Provider Demographics
NPI:1144043969
Name:CLARA HAVEN LLC
Entity type:Organization
Organization Name:CLARA HAVEN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:OSATO
Authorized Official - Last Name:OSUNBOR
Authorized Official - Suffix:
Authorized Official - Credentials:COTA
Authorized Official - Phone:214-991-8235
Mailing Address - Street 1:2002 VILLAGE GREEN DR
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75044-7142
Mailing Address - Country:US
Mailing Address - Phone:214-991-8235
Mailing Address - Fax:
Practice Address - Street 1:2002 VILLAGE GREEN DR
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75044-7142
Practice Address - Country:US
Practice Address - Phone:214-991-8235
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-01
Last Update Date:2024-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist