HALE KUPUNA HERITAGE HOME, LLC


Address: 4297c Omao Rd, Koloa, HI 96756-9624
Phone: 8087427591

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).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 313M00000X Nursing Facility/Intermediate Care Facility 61-N HI Nursing & Custodial Care Facilities

Other Provider Identifier

State Issuer Identifier Type Code
HI 521030-01 05

Office Location

Street Address 4297C OMAO RD
City KOLOA
State HI
Zip Code 96756-9624

Providers in the same zip code

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 Information

Taxonomy Code 313M00000X
Grouping Nursing & Custodial Care Facilities
Classification Nursing Facility/Intermediate Care Facility

Taxonomy Definition

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.

Providers in the same taxonomy and state

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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Competitor

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City KOLOA
Zip Code 96756

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Dataset Information

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.

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