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General NPI Number Information
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NPI Number | 1790582120
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Entity Type | Organization
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Legal Business Name | WESTCARE PACIFIC ISLANDS
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Dates
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Enumeration Date | 02/25/2025
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Last Update Date | 02/25/2025
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Provider Practice Location Address
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Address Line | 222 E CHALAN SANTO PAPA
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City | HAGATNA
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State | GU
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Zip | 96910-5161
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Country | US
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Telephone | 671-472-0218
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Fax |
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Provider Business Mailing Address
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Address Line | 402 E MARINE CORPS DR STE 200
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City | HAGATNA
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State | GU
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Zip | 96910-5184
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Country | US
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Telephone | 671-472-0218
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Fax |
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Authorized Official
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Title or Position | COO
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Name | AJA RAMOS
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Credential |
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Telephone | 671-472-0218
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1100X
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Taxonomy Name | Military/U.S. Coast Guard Outpatient Clinic/Center
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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 | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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