Provider Demographics
NPI:1992158117
Name:GOLDEN HAVEN SERVICES INC
Entity type:Organization
Organization Name:GOLDEN HAVEN SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:PASCHAL
Authorized Official - Middle Name:
Authorized Official - Last Name:EJERENWA
Authorized Official - Suffix:
Authorized Official - Credentials:MSC
Authorized Official - Phone:832-744-0566
Mailing Address - Street 1:25922 SUMMER SAVORY LN
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-1275
Mailing Address - Country:US
Mailing Address - Phone:832-744-0566
Mailing Address - Fax:
Practice Address - Street 1:25922 SUMMER SAVORY LN
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-1275
Practice Address - Country:US
Practice Address - Phone:832-744-0566
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-22
Last Update Date:2022-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities