Healthcare Provider Details

I. General information

NPI: 1295259281
Provider Name (Legal Business Name): HAPPY HOME CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/01/2017
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4222 N 12TH ST STE 102
PHOENIX AZ
85014-6023
US

IV. Provider business mailing address

4222 N 12TH ST STE 102
PHOENIX AZ
85014-6023
US

V. Phone/Fax

Practice location:
  • Phone: 602-995-2643
  • Fax: 602-995-2643
Mailing address:
  • Phone: 602-995-2643
  • Fax: 602-995-2643

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. MOSLEY OGBANGA
Title or Position: OWNER
Credential:
Phone: 602-995-2643