Provider Demographics
NPI:1790554095
Name:HAPPY JOURNEY AT STANSBERRY LLC
Entity Type:Organization
Organization Name:HAPPY JOURNEY AT STANSBERRY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:VICKY
Authorized Official - Middle Name:
Authorized Official - Last Name:JIAO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-883-9188
Mailing Address - Street 1:2529 STANSBERRY WAY
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95826-2122
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2529 STANSBERRY WAY
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95826-2122
Practice Address - Country:US
Practice Address - Phone:916-883-9188
Practice Address - Fax:916-345-1916
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-28
Last Update Date:2023-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility