Provider Demographics
NPI:1649640913
Name:HAPPY VALLEY, LLC
Entity type:Organization
Organization Name:HAPPY VALLEY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICARE CONSULTANT
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMSEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-766-6662
Mailing Address - Street 1:PO BOX 566
Mailing Address - Street 2:
Mailing Address - City:MALVERN
Mailing Address - State:AR
Mailing Address - Zip Code:72104-0566
Mailing Address - Country:US
Mailing Address - Phone:501-467-3339
Mailing Address - Fax:501-467-3390
Practice Address - Street 1:955 DIVISION ST
Practice Address - Street 2:
Practice Address - City:MALVERN
Practice Address - State:AR
Practice Address - Zip Code:72104-2309
Practice Address - Country:US
Practice Address - Phone:501-467-3339
Practice Address - Fax:501-467-3390
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-30
Last Update Date:2015-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR656314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility