HALE KOKUA INC. NPI 1174720072

NPI Information

NPI: 1174720072
Provider Name: HALE KOKUA, INC.

Other Name: BAY HORIZON ICF / DDH

Classification: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities - 320900000X
Entity Type: Organization
Address:
516 OCEAN VIEW AVE
SAN MATEO, CA
ZIP 94401
Phone: (650) 347-1164
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HALE KOKUA, INC. is a community based residential treatment facility, intellectual and/or developmental disabilities in San Mateo, CA. The provider is a home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. HALE KOKUA, INC. NPI is 1174720072. The provider is registered as an organization entity type.
The provider Other Name Is Bay Horizon Icf / Ddh.

The provider's business location address is:

516 OCEAN VIEW AVE
SAN MATEO, CA
ZIP 94401-029
Phone: (650) 347-1164

The provider's authorized official is Pureza A. Ganio .
The authorized official title is Licensee and has the following contact phone number (650) 520-5545.

The enumeration date for this NPI number is 7/2/2007 and was last updated on 1/21/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	320900000X	Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities		220000319	CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	LTC60671G	OTHER	CALIFORNIA	PROVIDER NUMBER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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