1316018443 NPI number — KALIHI REHAB CENTER, LLC

Table of content: (NPI 1316018443)

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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