Healthcare Provider Details

I. General information

NPI: 1447736996
Provider Name (Legal Business Name): HANA HOME HEALTH CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2018
Last Update Date: 12/14/2020
Certification Date: 12/14/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

223 W ANDERSON LN STE A110
AUSTIN TX
78752-1109
US

IV. Provider business mailing address

223 W ANDERSON LN STE A110
AUSTIN TX
78752-1109
US

V. Phone/Fax

Practice location:
  • Phone: 512-284-7757
  • Fax: 512-777-5044
Mailing address:
  • Phone: 512-284-7757
  • Fax: 512-777-5044

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number015575
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. RYAN W KIM
Title or Position: ADMINISTRATOR/OWNER
Credential:
Phone: 512-284-7757