Healthcare Provider Details

I. General information

NPI: 1144194226
Provider Name (Legal Business Name): ALOHA AND SHARON LEGACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2025
Last Update Date: 10/02/2025
Certification Date: 10/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 PRINCE WAY
RENO NV
89503-2222
US

IV. Provider business mailing address

1800 PRINCE WAY
RENO NV
89503-2222
US

V. Phone/Fax

Practice location:
  • Phone: 248-521-7810
  • Fax:
Mailing address:
  • Phone: 248-521-7810
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3104A0625X
TaxonomyAssisted Living Facility (Mental Illness)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3104A0630X
TaxonomyAssisted Living Facility (Behavioral Disturbances)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State

VIII. Authorized Official

Name: MARCUS RAUDSZUS
Title or Position: OWNER
Credential:
Phone: 248-521-7810