Provider Demographics
NPI: | 1891482014 |
---|---|
Name: | HANAI FAMILY SERVICES LLC |
Entity type: | Organization |
Organization Name: | HANAI FAMILY SERVICES LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | OWNER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | ISSAC |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | TEISINA |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 801-928-4656 |
Mailing Address - Street 1: | 2758 S REDBRIDGE WAY |
Mailing Address - Street 2: | |
Mailing Address - City: | WEST VALLEY CITY |
Mailing Address - State: | UT |
Mailing Address - Zip Code: | 84120-5078 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 801-928-4656 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 2758 S REDBRIDGE WAY |
Practice Address - Street 2: | |
Practice Address - City: | WEST VALLEY CITY |
Practice Address - State: | UT |
Practice Address - Zip Code: | 84120-5078 |
Practice Address - Country: | US |
Practice Address - Phone: | 801-928-4656 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2023-04-18 |
Last Update Date: | 2023-04-18 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 385H00000X | Respite Care Facility | Respite Care | |
No | 251S00000X | Agencies | Community/Behavioral Health | |
No | 253Z00000X | Agencies | In Home Supportive Care | |
No | 3104A0625X | Nursing & Custodial Care Facilities | Assisted Living Facility | Assisted Living, Mental Illness |
No | 3104A0630X | Nursing & Custodial Care Facilities | Assisted Living Facility | Assisted Living, Behavioral Disturbances |
No | 311Z00000X | Nursing & Custodial Care Facilities | Custodial Care Facility | |
No | 261QA0600X | Ambulatory Health Care Facilities | Clinic/Center | Adult Day Care |
No | 310400000X | Nursing & Custodial Care Facilities | Assisted Living Facility | |
No | 251C00000X | Agencies | Day Training, Developmentally Disabled Services | |
No | 311ZA0620X | Nursing & Custodial Care Facilities | Custodial Care Facility | Adult Care Home |
No | 315P00000X | Nursing & Custodial Care Facilities | Intermediate Care Facility, Intellectual Disabilities | |
No | 320700000X | Residential Treatment Facilities | Residential Treatment Facility, Physical Disabilities | |
No | 320800000X | Residential Treatment Facilities | Community Based Residential Treatment Facility, Mental Illness | |
No | 320900000X | Residential Treatment Facilities | Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |