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NPI Code Detail

MEDICARE: HAPPY HOUSE SOCIAL CLUB LLC

MEDICARE: HAPPY HOUSE SOCIAL CLUB LLC
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
1261QA0600XAdult Day Care Clinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1962075507
Entity Type Code : Organization
Provider Name (Legal Business Name) : HAPPY HOUSE SOCIAL CLUB LLC
Provider Business Mailing Address
First Line : 5837 LAKE WORTH RD
Second Line :
City : GREENACRES
State : FL
Zip : 33463-3209
Country : US
Telephone Number : 561-508-3799
Fax Number : 561-990-1347
Provider Business Practice Location Address
First Line : 5837 LAKE WORTH RD
Second Line :
City : GREENACRES
State : FL
Zip : 33463-3209
Country : US
Telephone Number : 561-508-3799
Fax Number : 561-990-1347
Authorized Official
Title or Position : VICE PRESIDENT
Name : ALIAN MESA RIBET
Credential :
Telephone Number : 561-508-3799
Provider Enumeration Date : 07/21/2021
Last Update Date : 07/21/2021

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Directions to “HAPPY HOUSE SOCIAL CLUB LLC ” Practice Location

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