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General NPI Number Information
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NPI Number | 1861634529
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Entity Type | Organization
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Legal Business Name | MANAWA LEA HEALTH SERVICES INC
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Dates
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Enumeration Date | 03/27/2009
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Last Update Date | 03/27/2009
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Provider Practice Location Address
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Address Line | 94-673 KUPUOHI STREET C108
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City | WAIPAHU
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State | HI
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Zip | 96797-5372
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Country | US
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Telephone | 808-686-9800
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Fax | 808-484-5636
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Provider Business Mailing Address
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Address Line | PO BOX 1089
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City | AIEA
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State | HI
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Zip | 96701-1089
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Country | US
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Telephone | 808-484-5635
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Fax | 808-484-5636
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. MARIA MAGDALENA RABAGO
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Credential | RN
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Telephone | 808-484-5635
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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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