Provider Demographics
NPI:1164891974
Name:HANA CARE INC.
Entity Type:Organization
Organization Name:HANA CARE INC.
Other - Org Name:HANA CARE REHAB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING PARTNER CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:NIEMAT
Authorized Official - Middle Name:
Authorized Official - Last Name:ISSA
Authorized Official - Suffix:
Authorized Official - Credentials:OTRL
Authorized Official - Phone:904-768-9966
Mailing Address - Street 1:PO BOX 551373
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32255-1373
Mailing Address - Country:US
Mailing Address - Phone:904-768-9966
Mailing Address - Fax:904-367-8760
Practice Address - Street 1:1771 EDGEWOOD AVE W STE 6B
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32208-7208
Practice Address - Country:US
Practice Address - Phone:904-768-9966
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-22
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)
No251B00000XAgenciesCase Management