Healthcare Provider Details

I. General information

NPI: 1053103556
Provider Name (Legal Business Name): HAPPY ACRES CHILDREN'S HOME INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2025
Last Update Date: 05/20/2025
Certification Date: 05/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24500 N 72ND AVE
PEORIA AZ
85383-3231
US

IV. Provider business mailing address

24500 N 72ND AVE
PEORIA AZ
85383-3231
US

V. Phone/Fax

Practice location:
  • Phone: 480-678-7870
  • Fax:
Mailing address:
  • Phone: 480-678-7870
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253J00000X
TaxonomyFoster Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code322D00000X
TaxonomyEmotionally Disturbed Childrens' Residential Treatment Facility
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code323P00000X
TaxonomyPsychiatric Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: CHRISY BLEVINS
Title or Position: EXECUTIVE ASSISTANT/ RN
Credential: RN
Phone: 480-678-7870