South Grant Icf / Ddh

LBN: Hale Kokua, Inc.
South Grant Icf / Ddh is an health care organization with primary practice located at 1618 S Grant St , San Mateo CA 94402-2657. The organization recently has only one registered license in Residential Treatment Facilities / Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities, which is considered as the primary health care specialty. Hale Kokua, Inc. can be contacted via phone (650) 578-1183, or through Ganio, Pureza A. via phone (650) 520-5545.

Contact Information

Primary practice address
1618 S Grant St San Mateo CA 94402-2657
Phone: (650) 578-1183
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Ganio, Pureza A.
Phone: (650) 520-5545

Health care specialties

SpecialtyCodeLicense #State
Residential Treatment Facilities / Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 320600000X 220000232 California

Profile Details

NPI number 1073710976
LBN Legal business name Hale Kokua, Inc.
DBA Doing business as South Grant Icf / Ddh
Authorized official Ganio, Pureza A.
Entity Organization
Organization subpart 1 No
Enumeration date Jul 2nd, 2007
Last updated Jan 21st, 2015 - about 10 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1073710976 NPPES
California Other LTC60789H PROVIDER NUMBER

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