| NPI | 1174206957 |
|---|---|
| Doing Business As | GREEN HAVEN GROUP HOME |
| Entity Type | Organization |
| Authorized Contact | ALI ADEM Manager 408-561-2324 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility |
| Enumeration Date | 2023-08-09 |
| Last Update Date | 2023-08-09 |