Provider Demographics
NPI:1194051839
Name:PASIANA SPELLICY
Entity type:Organization
Organization Name:PASIANA SPELLICY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CNA
Authorized Official - Prefix:MRS
Authorized Official - First Name:PASIANA
Authorized Official - Middle Name:MAGSAYO
Authorized Official - Last Name:SPELLICY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-214-6065
Mailing Address - Street 1:17 KUULA ST
Mailing Address - Street 2:
Mailing Address - City:KAHULUI
Mailing Address - State:HI
Mailing Address - Zip Code:96732-2906
Mailing Address - Country:US
Mailing Address - Phone:808-214-6965
Mailing Address - Fax:
Practice Address - Street 1:17 KUULA ST
Practice Address - Street 2:
Practice Address - City:KAHULUI
Practice Address - State:HI
Practice Address - Zip Code:96732-2906
Practice Address - Country:US
Practice Address - Phone:808-214-6965
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-31
Last Update Date:2009-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIW09834492-01311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home