Provider Demographics
NPI:1558035857
Name:HAPPY DAZE ADULT DAY SERVICES LLC
Entity Type:Organization
Organization Name:HAPPY DAZE ADULT DAY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHELIA
Authorized Official - Middle Name:
Authorized Official - Last Name:COLEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-744-2675
Mailing Address - Street 1:PO BOX 242
Mailing Address - Street 2:
Mailing Address - City:ANGUILLA
Mailing Address - State:MS
Mailing Address - Zip Code:38721-0242
Mailing Address - Country:US
Mailing Address - Phone:662-744-2675
Mailing Address - Fax:
Practice Address - Street 1:313 HOLLAND ST
Practice Address - Street 2:
Practice Address - City:ANGUILLA
Practice Address - State:MS
Practice Address - Zip Code:38721-3872
Practice Address - Country:US
Practice Address - Phone:662-744-2675
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-02
Last Update Date:2021-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care