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General NPI Number Information
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NPI Number | 1376731869
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Entity Type | Organization
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Legal Business Name | HAPPY HAVEN HOMES
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Dates
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Enumeration Date | 10/09/2007
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Last Update Date | 10/09/2007
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Provider Practice Location Address
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Address Line | 11365 PERRET ST
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City | HAMMOND
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State | LA
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Zip | 70401-4605
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Country | US
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Telephone | 985-543-0574
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Fax | 985-542-2832
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Provider Business Mailing Address
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Address Line | 42630 HINSON RD P.O. BOX 3092
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City | HAMMOND
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State | LA
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Zip | 70403-3216
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Country | US
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Telephone | 985-543-0574
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Fax | 985-542-2832
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Authorized Official
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Title or Position | ASST. ADMIN.
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Name | RANDALL J SMITH
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Credential |
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Telephone | 985-543-0574
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number | 534
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License Number State | LA
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