Healthcare Provider Details

I. General information

NPI: 1306591508
Provider Name (Legal Business Name): OHANA CARETAKERS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/16/2022
Last Update Date: 02/16/2022
Certification Date: 02/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

92-1628 LUAU DR
OCEAN VIEW HI
96737
US

IV. Provider business mailing address

PO BOX 377331
OCEAN VIEW HI
96737-7331
US

V. Phone/Fax

Practice location:
  • Phone: 808-990-1611
  • Fax:
Mailing address:
  • Phone: 808-990-1611
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. AMANDA SORENSON
Title or Position: ADMINISTRATOR
Credential:
Phone: 808-990-1611