Provider Demographics
NPI:1720351851
Name:HAPPY VALLEY DAY FACILITY II LLC
Entity Type:Organization
Organization Name:HAPPY VALLEY DAY FACILITY II LLC
Other - Org Name:HAPPY VALLEY DAY FACILITY II LLC
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TAMIKO
Authorized Official - Middle Name:MICHELL
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:706-322-7185
Mailing Address - Street 1:600 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31901-2906
Mailing Address - Country:US
Mailing Address - Phone:706-322-7185
Mailing Address - Fax:706-322-7199
Practice Address - Street 1:600 2ND AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31901
Practice Address - Country:US
Practice Address - Phone:706-322-7185
Practice Address - Fax:706-322-7199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-21
Last Update Date:2012-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No251S00000XAgenciesCommunity/Behavioral Health