Healthcare Provider Details

I. General information

NPI: 1053767525
Provider Name (Legal Business Name): HAPPY FAMILY ADULT DAY CARE CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2016
Last Update Date: 05/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

413 NE VAN LOON LN SUITE 110
CAPE CORAL FL
33909-2525
US

IV. Provider business mailing address

413 NE VAN LOON LN SUITE 110
CAPE CORAL FL
33909-2525
US

V. Phone/Fax

Practice location:
  • Phone: 239-800-3803
  • Fax: 239-800-3820
Mailing address:
  • Phone: 239-800-3803
  • Fax: 239-800-3820

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number StateFL

VIII. Authorized Official

Name: MRS. YUDEY MIRANDA PEREDA
Title or Position: OWNER
Credential:
Phone: 239-800-3803