Provider Demographics
NPI:1962281303
Name:HALE OHANA CARE LLC
Entity type:Organization
Organization Name:HALE OHANA CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:MR
Authorized Official - First Name:RAENIELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:SUNGA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:253-256-3088
Mailing Address - Street 1:10713 WESTWOOD DR SW
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98499-4827
Mailing Address - Country:US
Mailing Address - Phone:253-256-3088
Mailing Address - Fax:
Practice Address - Street 1:10713 WESTWOOD DR SW
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:WA
Practice Address - Zip Code:98499-4827
Practice Address - Country:US
Practice Address - Phone:253-256-3088
Practice Address - Fax:253-256-3104
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-25
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home