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General NPI Number Information
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NPI Number | 1720691082
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Entity Type | Organization
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Legal Business Name | OHANA IN HOME SENIOR CARE LLC
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Dates
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Enumeration Date | 08/26/2020
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Last Update Date | 08/26/2020
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Provider Practice Location Address
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Address Line | 421 W GEORGIA ST
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City | TALLAHASSEE
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State | FL
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Zip | 32301-1011
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Country | US
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Telephone | 850-270-7331
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Fax |
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Provider Business Mailing Address
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Address Line | 105 MARY BROWN RD
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City | QUINCY
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State | FL
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Zip | 32352-0394
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Country | US
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Telephone | 850-274-0414
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Fax |
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Authorized Official
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Title or Position | OWNER/ ADMINISTRATOR
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Name | NAEISHA SANDERS
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Credential |
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Telephone | 850-270-7331
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 385HR2060X
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Taxonomy Name | Child Intellectual and/or Developmental Disabilities Respite Care
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License Number |
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License Number State |
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Taxonomy #4
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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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