Provider Demographics
NPI:1083998181
Name:RESIDENTIAL CHOICES, INC
Entity Type:Organization
Organization Name:RESIDENTIAL CHOICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:MERGELINE
Authorized Official - Middle Name:A
Authorized Official - Last Name:BERUEDA
Authorized Official - Suffix:
Authorized Official - Credentials:RN, CM
Authorized Official - Phone:808-676-3948
Mailing Address - Street 1:94-450 MOKUOLA ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:WAIPAHU
Mailing Address - State:HI
Mailing Address - Zip Code:96797
Mailing Address - Country:US
Mailing Address - Phone:808-676-3948
Mailing Address - Fax:808-676-9507
Practice Address - Street 1:94-450 MOKUOLA ST
Practice Address - Street 2:SUITE 202
Practice Address - City:WAIPAHU
Practice Address - State:HI
Practice Address - Zip Code:96797
Practice Address - Country:US
Practice Address - Phone:808-676-3948
Practice Address - Fax:808-676-9507
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-06
Last Update Date:2015-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI486141OtherOHANA HEALTH PLAN
HI508707Medicaid