Provider Demographics
NPI:1659617371
Name:HAPPINESS LIFE CENTER, INC
Entity Type:Organization
Organization Name:HAPPINESS LIFE CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:M
Authorized Official - Last Name:KATZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:386-868-3892
Mailing Address - Street 1:840 DUNLAWTON AVE
Mailing Address - Street 2:SUITE D
Mailing Address - City:PORT ORANGE
Mailing Address - State:FL
Mailing Address - Zip Code:32127-4223
Mailing Address - Country:US
Mailing Address - Phone:386-868-3892
Mailing Address - Fax:386-506-8255
Practice Address - Street 1:840 DUNLAWTON AVE
Practice Address - Street 2:SUITE D
Practice Address - City:PORT ORANGE
Practice Address - State:FL
Practice Address - Zip Code:32127-4223
Practice Address - Country:US
Practice Address - Phone:386-868-3892
Practice Address - Fax:386-506-8255
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-28
Last Update Date:2012-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9213261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL006794900Medicaid