Provider Demographics
NPI:1083331300
Name:HAPPY FACE BEHAVIORAL THERAPY SERVICE INC
Entity Type:Organization
Organization Name:HAPPY FACE BEHAVIORAL THERAPY SERVICE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:YUSIMI
Authorized Official - Middle Name:
Authorized Official - Last Name:DOMINGUEZ HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-468-0397
Mailing Address - Street 1:4610 WEYMOUTH ST
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33463-2252
Mailing Address - Country:US
Mailing Address - Phone:768-468-0397
Mailing Address - Fax:
Practice Address - Street 1:607 SW SAINT LUCIE CRES STE 101
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-2851
Practice Address - Country:US
Practice Address - Phone:786-468-0397
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-26
Last Update Date:2022-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty