Healthcare Provider Details

I. General information

NPI: 1235758236
Provider Name (Legal Business Name): HAPPY LIFE HOME HEALTH SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/10/2020
Last Update Date: 04/10/2020
Certification Date: 04/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2770 S MARYLAND PKWY SUITE 205-B
LAS VEGAS NV
89109
US

IV. Provider business mailing address

2770 S MARYLAND PKWY SUITE 205-B
LAS VEGAS NV
89109
US

V. Phone/Fax

Practice location:
  • Phone: 725-206-5714
  • Fax: 725-217-5555
Mailing address:
  • Phone: 725-206-5714
  • Fax: 725-217-5555

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code372500000X
TaxonomyChore Provider
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: VIVIAN LATOZA VILLASTER
Title or Position: ADMINISTRATOR
Credential:
Phone: 702-334-3682