1144705286 NPI number — OHANA THERAPY CLINIC

Table of content: (NPI 1144705286)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144705286 NPI number — OHANA THERAPY CLINIC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
OHANA THERAPY CLINIC
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:
1144705286
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/16/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1422 STARLIGHT DRIVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CANTONMENT
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32533-7782
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
850-525-3487
Provider Business Mailing Address Fax Number:
855-424-3031

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1422 STARLIGHT DRIVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CANTONMENT
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32533-7782
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-457-1000
Provider Business Practice Location Address Fax Number:
855-424-3031
Provider Enumeration Date:
09/25/2018

Additional Information

Authorized Official

Authorized Official Last Name:
MILNE
Authorized Official First Name:
HANNAH
Authorized Official Middle Name:
ELIZABETH
Authorized Official Title or Position:
SPEECH LANGUAGE PATHOLOGIST
Authorized Official Telephone Number:
808-457-1000

Provider Taxonomy Codes

  • Taxonomy code: 235Z00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 14329347 . This is a "CAQH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1497130876 . This is a "NPI" identifier . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com