Hale Kokua, Inc. in San Mateo - Community Based Residential Treatment Facility, Intellectual And/or Developmental Disabilities
Hale Kokua, Inc. - NPI 1174720072
Hale Kokua, Inc. is a Community Based Residential Treatment Facility, Intellectual And/or Developmental Disabilities in San Mateo, California. Hale Kokua, Inc. practices all healthcare services and medical treatments related to Community Based Residential Treatment Facility, Intellectual And/or Developmental Disabilities. The NPI Number for Hale Kokua, Inc. is 1174720072. The last update date is 2015-01-21.
Hale Kokua, Inc.'s current location address is 1433 Dakota Avenue, San Mateo, California. You can contact this provider via phone number 6506854779 and fax number 6506274357. The mailing address for Hale Kokua, Inc. is 1433 Dakota Avenue, San Mateo, California. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Hale Kokua, Inc. |
|---|---|
| Address | 1433 Dakota Avenue, San Mateo, California |
| Phone Number | 6506854779 |
| Fax Number | 6506274357 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | LICENSEE |
|---|---|
| Authorized Official Name | Ganio A. Pureza |
| Telephone Number | 6505205545 |
NPI Number Detail
| NPI Number | 1174720072 |
|---|---|
| Provider Enumeration Date | 2007-07-02 |
| Last Updated Date | 2015-01-21 |
Provider Mailing Address Detail
| Address | 1433 Dakota Avenue |
|---|---|
| City | San Mateo |
| State | California (CA) |
| Post Code | 94401 |
| Phone Number | 6506854779 |
| Fax Number | 6506274357 |
Provider's Primary Taxonomy Detail
| Speciality | Community Based Residential Treatment Facility, Intellectual And/or Developmental Disabilities |
|---|---|
| Taxonomy | 320900000X |
| Licence No | 220000319 |
|
Definition: A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| LTC60671G | CA | PROVIDER NUMBER |
Post Comment/ Review Below
What is the unique identification code assigned to Hale Kokua, Inc. by the Centers for Medicare & Medicaid Services?
The Hale Kokua, Inc. has been issued the NPI (National Provider Identifier) 1174720072. This 10-digit code serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you provide the complete physical address where Hale Kokua, Inc. is located?
The Hale Kokua, Inc. is situated at the following address: 1433 Dakota Avenue, San Mateo, CA, 94401.
What is Hale Kokua, Inc.'s specialized field of practice, and what is the corresponding taxonomy classification code?
The Hale Kokua, Inc.'s area of specialization is Community Based Residential Treatment Facility, Intellectual And/or Developmental Disabilities, and the corresponding taxonomy code that categorizes this field of practice is 320900000X.
When did the Hale Kokua, Inc. receive its 1174720072?
The Hale Kokua, Inc. was issued its 1174720072 on 2007-07-02, which is the date when the organization was assigned this unique identifier.
As of what date were the details pertaining to Hale Kokua, Inc. last refreshed?
The information related to the Hale Kokua, Inc., including its address, specialty, and other relevant details, was last updated on 2015-01-21.
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