MEDICARE: SEVYN HAVEN HOMECARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3747P1801X	Personal Care Attendant

General Provider Information

NPI Number	:	1770305609
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SEVYN HAVEN HOMECARE LLC

Provider Business Mailing Address
First Line	:	1601 INDUSTRIAL BLVD STE 3068
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77478-2603
Country	:	US
Telephone Number	:	281-818-1735
Fax Number	:

Provider Business Practice Location Address
First Line	:	1601 INDUSTRIAL BLVD STE 3068
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77478-2603
Country	:	US
Telephone Number	:	281-818-1735
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR/CHIEF EXEC OFFICER
Name	:	MRS. SHMEKIA MILLER
Credential	:
Telephone Number	:	281-818-1735

Provider Enumeration Date	:	10/30/2024
Last Update Date	:	11/04/2024

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