1053672154 NPI number — SAFE HARBOR HOMECARE, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1053672154 NPI number — SAFE HARBOR HOMECARE, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SAFE HARBOR HOMECARE, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1053672154
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/05/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
99-115 AIEA HEIGHTS DR STE 250
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
AIEA
Provider Business Mailing Address State Name:
HI
Provider Business Mailing Address Postal Code:
96701-3975
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
808-488-8826
Provider Business Mailing Address Fax Number:
808-488-8827

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
99-115 AIEA HEIGHTS DR STE 250
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
AIEA
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96701-3975
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-488-8826
Provider Business Practice Location Address Fax Number:
808-488-8827
Provider Enumeration Date:
06/05/2012

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
RAMOS
Authorized Official First Name:
ESTER
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO/PRESIDENT
Authorized Official Telephone Number:
808-488-8826

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  HHA57 , registered in the state of HI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)