Healthcare Provider Details

I. General information

NPI: 1154189231
Provider Name (Legal Business Name): HAPPY HELPERS AUTISM CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/12/2024
Last Update Date: 08/26/2024
Certification Date: 08/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

134 WIND CHIME LN
ST AUGUSTINE FL
32095-0095
US

IV. Provider business mailing address

134 WIND CHIME LN
ST AUGUSTINE FL
32095-0095
US

V. Phone/Fax

Practice location:
  • Phone: 954-649-4760
  • Fax: 904-587-1433
Mailing address:
  • Phone: 954-649-4760
  • Fax: 904-587-1433

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: MELISSA LEIGH MASON
Title or Position: BCBA/CLINICAL DIRECTOR
Credential: BCBA
Phone: 954-649-4760