Provider Demographics
NPI:1639889553
Name:HAPPY PLACE ADC INC
Entity Type:Organization
Organization Name:HAPPY PLACE ADC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CAMILO
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ GARCIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:786-774-6505
Mailing Address - Street 1:2665 CLEVELAND AVE STE 105&107
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33901-5850
Mailing Address - Country:US
Mailing Address - Phone:239-323-4441
Mailing Address - Fax:239-306-7534
Practice Address - Street 1:2665 CLEVELAND AVE STE 105&107
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33901-5850
Practice Address - Country:US
Practice Address - Phone:239-323-4441
Practice Address - Fax:239-306-7534
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-01
Last Update Date:2022-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care