Provider Demographics
NPI:1528330594
Name:GLOW OF HAPPINESS
Entity type:Organization
Organization Name:GLOW OF HAPPINESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO-CO-FOUNDER
Authorized Official - Prefix:MS
Authorized Official - First Name:SONIA
Authorized Official - Middle Name:
Authorized Official - Last Name:FUENTES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:254-981-6351
Mailing Address - Street 1:200 W STATE HIGHWAY 6
Mailing Address - Street 2:SUIT 211
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76712-7923
Mailing Address - Country:US
Mailing Address - Phone:254-981-6351
Mailing Address - Fax:
Practice Address - Street 1:200 W STATE HIGHWAY 6
Practice Address - Street 2:SUIT 211
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76712-7923
Practice Address - Country:US
Practice Address - Phone:254-981-6351
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-06
Last Update Date:2012-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities