MEDICARE: HANAI FAMILY SERVICES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	251S00000X	Community/Behavioral Health Agency
2	253Z00000X	In Home Supportive Care Agency
3	3104A0625X	Assisted Living Facility (Mental Illness)
4	3104A0630X	Assisted Living Facility (Behavioral Disturbances)
5	311Z00000X	Custodial Care Facility
6	261QA0600X	Adult Day Care Clinic/Center
7	310400000X	Assisted Living Facility
8	251C00000X	Developmentally Disabled Services Day Training Agency
9	311ZA0620X	Adult Care Home Facility
10	315P00000X	Intellectual Disabilities Intermediate Care Facility
11	320700000X	Physical Disabilities Residential Treatment Facility
12	320800000X	Mental Illness Community Based Residential Treatment Facility
13	320900000X	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
14	385H00000X	Respite Care

General Provider Information

NPI Number	:	1891482014
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HANAI FAMILY SERVICES LLC

Provider Business Mailing Address
First Line	:	2758 S REDBRIDGE WAY
Second Line	:
City	:	WEST VALLEY CITY
State	:	UT
Zip	:	84120-5078
Country	:	US
Telephone Number	:	801-928-4656
Fax Number	:

Provider Business Practice Location Address
First Line	:	2758 S REDBRIDGE WAY
Second Line	:
City	:	WEST VALLEY CITY
State	:	UT
Zip	:	84120-5078
Country	:	US
Telephone Number	:	801-928-4656
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ISSAC TEISINA
Credential	:
Telephone Number	:	801-928-4656

Provider Enumeration Date	:	04/18/2023
Last Update Date	:	04/18/2023

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Directions to “HANAI FAMILY SERVICES LLC ” Practice Location

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