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General NPI Number Information
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NPI Number | 1992081558
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Entity Type | Organization
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Legal Business Name | HAPPY HAPPY AT HOME
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Dates
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Enumeration Date | 10/27/2011
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Last Update Date | 10/27/2011
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Provider Practice Location Address
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Address Line | 1122 CONEY ISLAND AVE
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City | BROOKLYN
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State | NY
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Zip | 11230-2345
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Country | US
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Telephone | 718-421-5111
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Fax |
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Provider Business Mailing Address
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Address Line | 1122 CONEY ISLAND AVE
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City | BROOKLYN
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State | NY
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Zip | 11230-2345
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | SERGE DYMERETS
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Credential |
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Telephone | 718-421-5111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number | 1176L007
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License Number State | NY
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