Provider Demographics
NPI:1235407776
Name:AIM TALAVERA. INC.
Entity Type:Organization
Organization Name:AIM TALAVERA. INC.
Other - Org Name:ADVANTAGE HEALTH CARE PROVIDER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:ATMOSPERA-WALCH
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN, MPH, NHA, E
Authorized Official - Phone:808-778-3832
Mailing Address - Street 1:1188 BISHOP ST
Mailing Address - Street 2:SUITE 1507
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-3301
Mailing Address - Country:US
Mailing Address - Phone:808-525-8888
Mailing Address - Fax:808-536-7200
Practice Address - Street 1:1188 BISHOP ST
Practice Address - Street 2:SUITE 1507
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-3301
Practice Address - Country:US
Practice Address - Phone:808-525-8888
Practice Address - Fax:808-536-7200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-13
Last Update Date:2011-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIW78189882-01251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services