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General NPI Number Information
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NPI Number | 1336870708
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Entity Type | Organization
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Legal Business Name | OHANA ASSISTED LIVING
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Dates
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Enumeration Date | 06/17/2022
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Last Update Date | 06/17/2022
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Provider Practice Location Address
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Address Line | 8602 N 22ND ST
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City | TAMPA
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State | FL
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Zip | 33604-2104
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Country | US
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Telephone | 727-851-3830
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Fax |
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Provider Business Mailing Address
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Address Line | 8090 50TH AVE N
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City | SAINT PETERSBURG
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State | FL
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Zip | 33709-2232
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Country | US
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Telephone | 727-851-3830
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JAKAYLA L MCKENZIE
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Credential |
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Telephone | 727-851-3830
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3104A0625X
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Taxonomy Name | Assisted Living Facility (Mental Illness)
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License Number |
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License Number State |
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