Provider Demographics
NPI:1962679613
Name:HAPPY HOME
Entity Type:Organization
Organization Name:HAPPY HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED NURSE/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:GERALDINE
Authorized Official - Middle Name:DOLORES
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-445-7282
Mailing Address - Street 1:4635 LORD RD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78220-3541
Mailing Address - Country:US
Mailing Address - Phone:210-445-7282
Mailing Address - Fax:210-493-8289
Practice Address - Street 1:4635 LORD RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78220-3541
Practice Address - Country:US
Practice Address - Phone:210-445-7282
Practice Address - Fax:210-493-8289
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-13
Last Update Date:2008-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX122977310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility