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General NPI Number Information
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NPI Number | 1649640913
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Entity Type | Organization
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Legal Business Name | HAPPY VALLEY, LLC
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Dates
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Enumeration Date | 09/30/2015
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Last Update Date | 11/03/2015
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Provider Practice Location Address
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Address Line | 955 DIVISION ST
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City | MALVERN
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State | AR
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Zip | 72104-2309
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Country | US
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Telephone | 501-467-3339
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Fax | 501-467-3390
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Provider Business Mailing Address
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Address Line | PO BOX 566
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City | MALVERN
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State | AR
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Zip | 72104-0566
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Country | US
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Telephone | 501-467-3339
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Fax | 501-467-3390
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Authorized Official
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Title or Position | MEDICARE CONSULTANT
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Name | CHRISTINA RAMSEY
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Credential |
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Telephone | 501-766-6662
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 656
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License Number State | AR
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