Healthcare Provider Details
I. General information
NPI: 1235797457
Provider Name (Legal Business Name): OHANA HOME HEALTHCARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/03/2019
Last Update Date: 06/03/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1990 NE 163RD ST STE 228
NORTH MIAMI BEACH FL
33162-4854
US
IV. Provider business mailing address
1990 NE 163RD ST STE 228
NORTH MIAMI BEACH FL
33162-4854
US
V. Phone/Fax
- Phone: 917-449-8105
- Fax:
- Phone: 917-449-8105
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251E00000X |
| Taxonomy | Home Health Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
GEORGE
REKBLATT
Title or Position: ADMINISTRATOR
Credential:
Phone: 917-449-8105