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General NPI Number Information
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NPI Number | 1609187426
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Entity Type | Organization
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Legal Business Name | EDITHA SORIA FOSTER HOME
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Dates
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Enumeration Date | 06/25/2010
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Last Update Date | 06/25/2010
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Provider Practice Location Address
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Address Line | 94-1055 KUHAULUA ST
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City | WAIPAHU
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State | HI
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Zip | 96797-2851
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Country | US
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Telephone | 808-692-3140
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Fax | 808-888-7605
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Provider Business Mailing Address
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Address Line | 94-1055 KUHAULUA ST
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City | WAIPAHU
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State | HI
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Zip | 96797-2851
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Country | US
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Telephone | 808-692-3140
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Fax | 808-888-7605
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Authorized Official
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Title or Position | CNA
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Name | MISS EDITHA PENGSON SORIA
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Credential | FOSTER HOME OERATOR
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Telephone | 808-692-3140
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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 |
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License Number State |
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