HALE KUPUNA HERITAGE HOME, LLC (NPI# 1992792733) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1992792733 |
Entity Type | Organization |
Organization Name | HALE KUPUNA HERITAGE HOME, LLC |
Practice Address |
4297c Omao Rd Koloa HI 96756-9624 |
Mailing Address |
45-181 Waikalua Rd Kaneohe HI 96744-2765 |
Practice Telephone | 8087427591 |
Practice Fax Number | 8087426563 |
Mailing Telephone | 8082470003 |
Enumeration Date | 2005-10-05 |
Last Update Date | 2015-03-31 |
Authorized Official Name | RANDALL HATA (CFO) |
Authorized Official Telephone | 8082470003 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 313M00000X | Nursing Facility/Intermediate Care Facility | 61-N | HI | Nursing & Custodial Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
HI | 521030-01 | 05 |
Street Address |
4297C OMAO RD |
City | KOLOA |
State | HI |
Zip Code | 96756-9624 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1275005712 | Hawaii Health Systems Corporation | Clinic/Center | 2829 Ala Kalanikaumaka St, Ste B-201, Koloa, HI 96756 | 2018-12-21 |
1073085528 | Hawaii Health Systems Corporation | Clinic/Center | 2829 Ala Kalanikuamaka St, Koloa, HI 96756 | 2018-12-21 |
1285054965 | Leia Makaneole | Massage Therapist | 2555a Ala Kinoiki Rd., Koloa, HI 96756 | 2014-04-22 |
1043549637 | Shanti Kay Manzano | Psychologist | 5476 Koloa Road, 2f, Koloa, HI 96756 | 2009-12-10 |
1467627075 | Margaret Bubon Smith | Counselor | 4055 Aka Rd, Koloa, HI 96756 | 2008-04-24 |
1376755330 | Holly Marie Poag | Emergency Medicine | 2829 Ala Kalanikaumaka St., Ste.b201, Koloa, HI 96756 | 2007-05-04 |
1871611558 | Kauai Medical Clinic | Durable Medical Equipment & Medical Supplies | Kauai Medical Clinic - Koloa Clinic, 5371 Koloa Rd, Koloa, HI 96756 | 2007-03-27 |
1548330657 | Joseph M. Murray | Family Medicine | 5371 Koloa Rd, Koloa, HI 96756 | 2006-11-08 |
1164413696 | Daniel S Choi | Anesthesiology | 3176 Poipu Rd, Koloa, HI 96756 | 2005-11-03 |
1801980339 | Edward Franklin De Deo | Chiropractor | 5470 Koloa Rd 2d, Koloa, HI 96756-0388 | 2006-10-02 |
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Taxonomy Code | 313M00000X |
Grouping | Nursing & Custodial Care Facilities |
Classification | Nursing Facility/Intermediate Care Facility |
An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals. |
Notes: Source: Paraphrased from Section 1919 (a) of the Social Security Act. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1225573124 | Lyndon Redona | Nursing Facility/Intermediate Care Facility | 94-1065 Lumiaina St, Waipahu, HI 96797-3912 | 2016-12-30 |
1073069134 | Manilyn B Nagtalon | Nursing Facility/Intermediate Care Facility | 91-1002 Fort Weaver Rd, Ewa Beach, HI 96706-2229 | 2016-08-29 |
1659658664 | Craigside Retirement Residence | Nursing Facility/Intermediate Care Facility | 15 Craigside Pl, Honolulu, HI 96817-1799 | 2011-11-04 |
1457412066 | Kohala Hospital | Nursing Facility/Intermediate Care Facility | 54 383 Hospital Rd, Kapaau, HI 96755 | 2006-12-13 |
1699782342 | Kahala Senior Living Community Inc | Nursing Facility/Intermediate Care Facility | 4389 Malia St, Honolulu, HI 96821-1106 | 2006-08-02 |
1124063003 | Pc Care Corp | Nursing Facility/Intermediate Care Facility | 919 Lehua Ave, Pearl City, HI 96782-3328 | 2006-06-17 |
1558346528 | Maunalani Nursing and Rehabilitation Center | Nursing Facility/Intermediate Care Facility | 5113 Maunalani Cir, Honolulu, HI 96816-4019 | 2005-12-13 |
1376525584 | Diversified Health Services | Nursing Facility/Intermediate Care Facility | 1900 Bachelot St, Honolulu, HI 96817-2431 | 2005-11-15 |
1598765414 | Leki, Incorporated | Nursing Facility/Intermediate Care Facility | 469 Ena Rd, 2301, Honolulu, HI 96815-1749 | 2005-07-21 |
1043214380 | Ocf Partners | Nursing Facility/Intermediate Care Facility | 1808 S Beretania St, Honolulu, HI 96826-1305 | 2005-06-01 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.