Provider Demographics
NPI:1003863853
Name:HAPPY HAVEN HOMES INC.
Entity Type:Organization
Organization Name:HAPPY HAVEN HOMES INC.
Other - Org Name:HAPPY DAYS WORKSHOP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMIN. ASSIST.
Authorized Official - Prefix:MR
Authorized Official - First Name:RANDALL
Authorized Official - Middle Name:J
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:985-543-0574
Mailing Address - Street 1:42630 HINSON RD
Mailing Address - Street 2:P.O. BOX 3092
Mailing Address - City:HAMMOND
Mailing Address - State:LA
Mailing Address - Zip Code:70403-3216
Mailing Address - Country:US
Mailing Address - Phone:985-543-0574
Mailing Address - Fax:985-542-2832
Practice Address - Street 1:1206 J W DAVIS DR
Practice Address - Street 2:STE. 105
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70403-5953
Practice Address - Country:US
Practice Address - Phone:985-543-0574
Practice Address - Fax:985-542-2832
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-27
Last Update Date:2007-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA101543104A0625X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1454109Medicaid