Provider Demographics
NPI:1366048951
Name:ARRYS HAVEN, LLC
Entity type:Organization
Organization Name:ARRYS HAVEN, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:OLUWASEYI
Authorized Official - Middle Name:TAMI
Authorized Official - Last Name:YOUNG-HARRY
Authorized Official - Suffix:
Authorized Official - Credentials:DHA
Authorized Official - Phone:619-414-4303
Mailing Address - Street 1:1002 TABASCO TRL
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76002-3041
Mailing Address - Country:US
Mailing Address - Phone:619-414-4303
Mailing Address - Fax:
Practice Address - Street 1:1002 TABASCO TRL
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76002-3041
Practice Address - Country:US
Practice Address - Phone:619-414-4303
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-08
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health