Provider Demographics
NPI:1316018443
Name:KALIHI REHAB CENTER, LLC
Entity Type:Organization
Organization Name:KALIHI REHAB CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:NORA
Authorized Official - Middle Name:G
Authorized Official - Last Name:TAN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:808-847-7440
Mailing Address - Street 1:1427 N KING ST
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817-4226
Mailing Address - Country:US
Mailing Address - Phone:808-847-7440
Mailing Address - Fax:808-847-7409
Practice Address - Street 1:1427 N KING ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-4226
Practice Address - Country:US
Practice Address - Phone:808-847-7440
Practice Address - Fax:808-847-7409
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-11
Last Update Date:2014-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI485,933,976225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIH101437Medicaid
HIMAE-2024OtherMASSAGE ESTABLISHMENT
HIP.T. LICENSE# 485OtherNORA TAN
HIP.T. LINCENSE# 976OtherNORMA DOMINGO-DEXTER
HI0000250944OtherTRICARE NORA TAN
HIP.T. LICENSE# 933OtherLIN FAR LEE
HI520008OtherHMA NORA TAN
HI6852610OtherUHA NORA TAN
HI56434501Medicaid
ID0000250944OtherHMSA NORA TAN
HI4933610OtherUHA LIN FAR LEE
HIMAT# 7487OtherSHERYL MAEDA MASSAGE
HI0000259564OtherHMSA LIN FAR LEE
HIMAT -6653OtherMARIA THEA VISAYA
HIMAT-8529OtherMATILDE ABIDA
HIP.T. LICENSE# 485OtherNORA TAN
HIH101437Medicare ID - Type UnspecifiedLIN FAR LEE
HI0000259564OtherHMSA LIN FAR LEE
HIH101181Medicare ID - Type UnspecifiedTRADING PARTNER NUMBER
HIH100192Medicare ID - Type UnspecifiedNORA TAN