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General NPI Number Information
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NPI Number | 1023406709
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Entity Type | Organization
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Legal Business Name | OHANA CARE MAUI LLC
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Dates
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Enumeration Date | 01/02/2015
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Last Update Date | 01/02/2015
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Provider Practice Location Address
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Address Line | 2854 OMAOPIO RD
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City | KULA
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State | HI
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Zip | 96790-8865
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Country | US
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Telephone | 808-344-1285
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 344
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City | MAKAWAO
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State | HI
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Zip | 96768-0344
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Country | US
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Telephone | 808-344-1285
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. JESSIKA GALVEZ
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Credential | CNA
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Telephone | 808-344-1285
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | NOT AVAILABLE
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License Number State | HI
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