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General NPI Number Information
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NPI Number | 1710408877
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Entity Type | Organization
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Legal Business Name | OHANA CAREGIVERS LLC
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Dates
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Enumeration Date | 06/29/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 3091 W SANTA CRUZ AVE
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City | QUEEN CREEK
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State | AZ
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Zip | 85142-3022
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Country | US
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Telephone | 605-228-7765
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Fax |
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Provider Business Mailing Address
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Address Line | 3091 W SANTA CRUZ AVE
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City | QUEEN CREEK
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State | AZ
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Zip | 85142-3022
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Country | US
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Telephone | 605-228-7765
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KALLI PULLING
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Credential |
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Telephone | 605-228-7765
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | BH5103
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License Number State | AZ
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