Provider Demographics
NPI:1508107756
Name:HAPPY HOMECARE STAFFING
Entity Type:Organization
Organization Name:HAPPY HOMECARE STAFFING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LESA
Authorized Official - Middle Name:ANDREWS
Authorized Official - Last Name:KENDRICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-732-4663
Mailing Address - Street 1:6720 PENTECOST RD
Mailing Address - Street 2:
Mailing Address - City:CEDAR GROVE
Mailing Address - State:NC
Mailing Address - Zip Code:27231-9269
Mailing Address - Country:US
Mailing Address - Phone:919-732-4663
Mailing Address - Fax:919-732-4661
Practice Address - Street 1:224 ORANGE GROVE ST
Practice Address - Street 2:224D
Practice Address - City:HILLSBOROUGH
Practice Address - State:NC
Practice Address - Zip Code:27278-2175
Practice Address - Country:US
Practice Address - Phone:919-732-4663
Practice Address - Fax:919-732-4661
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-13
Last Update Date:2013-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC3555253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1154580181Medicaid
NC1003985474Medicaid