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General NPI Number Information
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NPI Number | 1902516602
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Entity Type | Organization
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Legal Business Name | OHANA SENIOR CARE, LLC
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Dates
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Enumeration Date | 12/05/2022
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Last Update Date | 11/24/2023
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Provider Practice Location Address
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Address Line | 1454 MIDDLE ST
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City | HONOLULU
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State | HI
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Zip | 96819-2501
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Country | US
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Telephone | 808-913-2067
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Fax | 808-913-2067
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Provider Business Mailing Address
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Address Line | 1454 MIDDLE ST
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City | HONOLULU
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State | HI
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Zip | 96819-2501
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Country | US
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Telephone | 808-913-2067
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Fax | 808-913-2067
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Authorized Official
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Title or Position | OWNER/MANAGING MEMBER
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Name | ANGEL LEAH BUENO AGBISIT
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Credential |
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Telephone | 808-913-2067
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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