Healthcare Provider Details

I. General information

NPI: 1346044708
Provider Name (Legal Business Name): HAPPY'S HOME LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2025
Last Update Date: 05/16/2025
Certification Date: 05/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 N 6TH ST STE B
BUCKEYE AZ
85326-2415
US

IV. Provider business mailing address

401 N 6TH ST STE B
BUCKEYE AZ
85326-2415
US

V. Phone/Fax

Practice location:
  • Phone: 623-401-6331
  • Fax: 623-233-6331
Mailing address:
  • Phone: 623-401-6331
  • Fax: 623-233-6331

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: JESSICA DIXON-TATUM
Title or Position: OWNER
Credential: LPN
Phone: 623-401-6331