Provider Demographics
NPI:1043434921
Name:A HAPPY PLACE ADULR CARE HOME, INC
Entity Type:Organization
Organization Name:A HAPPY PLACE ADULR CARE HOME, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MIKE
Authorized Official - Middle Name:
Authorized Official - Last Name:LUGOJ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-996-7750
Mailing Address - Street 1:4918 E KAREN DR
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-2237
Mailing Address - Country:US
Mailing Address - Phone:602-996-7750
Mailing Address - Fax:602-996-1333
Practice Address - Street 1:4918 E KAREN DR
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-2237
Practice Address - Country:US
Practice Address - Phone:602-996-7750
Practice Address - Fax:602-996-1333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZALH-5588310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ819914Medicaid