Provider Demographics
NPI:1154935872
Name:MY HAPPY PLACE WELLNESS CENTER
Entity type:Organization
Organization Name:MY HAPPY PLACE WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:POPE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-961-1008
Mailing Address - Street 1:38100 COLORADO AVE
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:OH
Mailing Address - Zip Code:44011-1031
Mailing Address - Country:US
Mailing Address - Phone:440-961-1008
Mailing Address - Fax:440-815-2287
Practice Address - Street 1:38100 COLORADO AVE
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:OH
Practice Address - Zip Code:44011-1031
Practice Address - Country:US
Practice Address - Phone:440-961-1008
Practice Address - Fax:440-815-2287
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-01
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0290155Medicaid
OH0414430Medicaid