Healthcare Provider Details

I. General information

NPI: 1073336624
Provider Name (Legal Business Name): OHANA HOME HEALTH CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/04/2024
Last Update Date: 12/11/2024
Certification Date: 12/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12235 BEACH BLVD STE 203
STANTON CA
90680-3953
US

IV. Provider business mailing address

12235 BEACH BLVD STE 203
STANTON CA
90680-3953
US

V. Phone/Fax

Practice location:
  • Phone: 562-539-7819
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: KEITH SPENCER
Title or Position: CEO
Credential:
Phone: 562-539-7819