Provider Demographics
NPI:1629669619
Name:GOLDEN HAPPINESS CORP
Entity Type:Organization
Organization Name:GOLDEN HAPPINESS CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LAZARO
Authorized Official - Middle Name:Y
Authorized Official - Last Name:BETANCOURT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-601-3899
Mailing Address - Street 1:2110 SW 82ND AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33155-1237
Mailing Address - Country:US
Mailing Address - Phone:786-942-8217
Mailing Address - Fax:
Practice Address - Street 1:2260 PALM BEACH LAKES BLVD STE 212-6
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33409-3411
Practice Address - Country:US
Practice Address - Phone:239-601-3899
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-01
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL109562400Medicaid