Provider Demographics
NPI:1760079842
Name:YOUR HAPPY PLACE RESIDENTIAL SERVICES
Entity Type:Organization
Organization Name:YOUR HAPPY PLACE RESIDENTIAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:HOLLY
Authorized Official - Middle Name:
Authorized Official - Last Name:LOVELY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-533-6929
Mailing Address - Street 1:1326 N BARRON ST
Mailing Address - Street 2:
Mailing Address - City:EATON
Mailing Address - State:OH
Mailing Address - Zip Code:45320-1016
Mailing Address - Country:US
Mailing Address - Phone:937-533-6929
Mailing Address - Fax:
Practice Address - Street 1:1326 N BARRON ST
Practice Address - Street 2:
Practice Address - City:EATON
Practice Address - State:OH
Practice Address - Zip Code:45320-1016
Practice Address - Country:US
Practice Address - Phone:937-533-6929
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-23
Last Update Date:2020-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health