Provider Demographics
NPI:1649304197
Name:HAPPY HOUSE ADULT DAY SERVICES, INC.
Entity type:Organization
Organization Name:HAPPY HOUSE ADULT DAY SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DANA
Authorized Official - Middle Name:
Authorized Official - Last Name:CAUDILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:606-886-0265
Mailing Address - Street 1:92 ARCHER PARK DR
Mailing Address - Street 2:PO BOX 1482
Mailing Address - City:PRESTONSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:41653-7917
Mailing Address - Country:US
Mailing Address - Phone:606-886-0265
Mailing Address - Fax:606-886-0259
Practice Address - Street 1:92 ARCHER PARK DR
Practice Address - Street 2:
Practice Address - City:PRESTONSBURG
Practice Address - State:KY
Practice Address - Zip Code:41653-7917
Practice Address - Country:US
Practice Address - Phone:606-886-0265
Practice Address - Fax:606-886-0259
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY7500054261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY43000363Medicaid