1316018443 NPI number — KALIHI REHAB CENTER, LLC

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 1316018443 NPI number — KALIHI REHAB CENTER, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
KALIHI REHAB CENTER, LLC
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:
1316018443
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/18/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1427 N KING ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HONOLULU
Provider Business Mailing Address State Name:
HI
Provider Business Mailing Address Postal Code:
96817-4226
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
808-847-7440
Provider Business Mailing Address Fax Number:
808-847-7409

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1427 N KING ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HONOLULU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96817-4226
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-847-7440
Provider Business Practice Location Address Fax Number:
808-847-7409
Provider Enumeration Date:
11/11/2006

Additional Information

Authorized Official

Authorized Official Last Name:
TAN
Authorized Official First Name:
NORA
Authorized Official Middle Name:
G
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
808-847-7440

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  485,933,976 , 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)

  • Identifier: H101437 , issued by the state of ( HI ) . This identifiers is of the category "MEDICAID".
  • Identifier: MAE-2024 . This is a "MASSAGE ESTABLISHMENT" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".
  • Identifier: P.T. LICENSE# 485 . This is a "NORA TAN" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".
  • Identifier: P.T. LINCENSE# 976 . This is a "NORMA DOMINGO-DEXTER" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".
  • Identifier: 0000250944 . This is a "TRICARE NORA TAN" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".
  • Identifier: P.T. LICENSE# 933 . This is a "LIN FAR LEE" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".
  • Identifier: 520008 . This is a "HMA NORA TAN" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".
  • Identifier: 6852610 . This is a "UHA NORA TAN" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".
  • Identifier: 56434501 , issued by the state of ( HI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0000250944 . This is a "HMSA NORA TAN" identifier , issued by the state of ( ID ) . This identifiers is of the category "OTHER".
  • Identifier: 4933610 . This is a "UHA LIN FAR LEE" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".
  • Identifier: MAT# 7487 . This is a "SHERYL MAEDA MASSAGE" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".
  • Identifier: 0000259564 . This is a "HMSA LIN FAR LEE" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".
  • Identifier: MAT -6653 . This is a "MARIA THEA VISAYA" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".
  • Identifier: MAT-8529 . This is a "MATILDE ABIDA" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".




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