MEDICARE: HAPPY HEARTS GROUP HOME

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1063291011
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HAPPY HEARTS GROUP HOME

Provider Business Mailing Address
First Line	:	6450 BURLINGTON RD
Second Line	:
City	:	WHITSETT
State	:	NC
Zip	:	27377-9716
Country	:	US
Telephone Number	:	336-944-7370
Fax Number	:	336-603-8764

Provider Business Practice Location Address
First Line	:	6450 BURLINGTON RD
Second Line	:
City	:	WHITSETT
State	:	NC
Zip	:	27377-9716
Country	:	US
Telephone Number	:	336-944-7370
Fax Number	:	336-603-8764

Authorized Official
Title or Position	:	CEO
Name	:	MISS LUCINDA M DAVIS
Credential	:
Telephone Number	:	336-944-7370

Provider Enumeration Date	:	09/27/2023
Last Update Date	:	09/27/2023

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