Provider Demographics
NPI:1548077480
Name:HAPPY HEARTS AT NATE'S PLACE
Entity type:Organization
Organization Name:HAPPY HEARTS AT NATE'S PLACE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JORDYN
Authorized Official - Middle Name:
Authorized Official - Last Name:LEASURE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-395-2459
Mailing Address - Street 1:160 DWYER ST
Mailing Address - Street 2:
Mailing Address - City:MADERA
Mailing Address - State:CA
Mailing Address - Zip Code:93637-5121
Mailing Address - Country:US
Mailing Address - Phone:559-395-2459
Mailing Address - Fax:
Practice Address - Street 1:160 DWYER ST
Practice Address - Street 2:
Practice Address - City:MADERA
Practice Address - State:CA
Practice Address - Zip Code:93637-5121
Practice Address - Country:US
Practice Address - Phone:559-395-2459
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-13
Last Update Date:2024-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
No251S00000XAgenciesCommunity/Behavioral Health