MEDICARE: HAVEN HAUS II INC.

Medicare Provider Information

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

#	Taxonomy Code	Taxonomy
1	251C00000X	Developmentally Disabled Services Day Training Agency
2	3747P1801X	Personal Care Attendant
3	163WG0000X	General Practice Registered Nurse
4	363LC1500X	Community Health Nurse Practitioner
5	372600000X	Adult Companion
6	320600000X	Intellectual and/or Developmental Disabilities Residential Treatment Facility
7	224ZF0002X	Feeding, Eating & Swallowing Occupational Therapy Assistant
8	320900000X	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
9	225XM0800X	Mental Health Occupational Therapist
10	347C00000X	Private Vehicle
11	374K00000X	Religious Nonmedical Practitioner
12	311ZA0620X	Adult Care Home Facility
13	2278H0200X	Home Health Certified Respiratory Therapist
14	225XP0019X	Physical Rehabilitation Occupational Therapist
15	320800000X	Mental Illness Community Based Residential Treatment Facility

NPI Number	:	1780528976
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HAVEN HAUS II INC.

Provider Business Mailing Address
First Line	:	7538 BUFORD DR
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75241-5408
Country	:	US
Telephone Number	:	305-988-7335
Fax Number	:

Provider Business Practice Location Address
First Line	:	7538 BUFORD DR
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75241-5408
Country	:	US
Telephone Number	:	305-988-7335
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DETRA L JACKSON
Credential	:
Telephone Number	:	305-988-7335

Provider Enumeration Date	:	04/17/2026
Last Update Date	:	04/20/2026

7538 BUFORD DR
DALLAS, TX
75241-5408

Practice Phone: 305-988-7335
Practice Fax: