| NPI | 1215770979 |
|---|---|
| Doing Business As | GREENHEAVEN BOARDING HOME |
| Entity Type | Organization |
| Authorized Contact | JOHN K MAINA CEO 214-695-2894 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 251C00000X Day Training, Developmentally Disabled Services |
| 261QA0600X Clinic/Center, Adult Day Care | |
| Enumeration Date | 2024-06-18 |
| Last Update Date | 2024-06-18 |