Provider Demographics
NPI:1104569656
Name:LAURENS HAVEN
Entity type:Organization
Organization Name:LAURENS HAVEN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LVN/CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:CATINA
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:SAULSBERRY
Authorized Official - Suffix:
Authorized Official - Credentials:LVN
Authorized Official - Phone:504-333-9969
Mailing Address - Street 1:PO BOX 852513
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75085-2513
Mailing Address - Country:US
Mailing Address - Phone:504-333-9969
Mailing Address - Fax:469-248-0051
Practice Address - Street 1:610 TOWNE HOUSE LN
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75081-3530
Practice Address - Country:US
Practice Address - Phone:504-333-9969
Practice Address - Fax:469-248-0051
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-13
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes164X00000XNursing Service ProvidersLicensed Vocational NurseGroup - Single Specialty
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care ProviderGroup - Multi-Specialty