Provider Demographics
NPI:1467681411
Name:OPPORTUNITES FOR THE RETARDED, INC.
Entity Type:Organization
Organization Name:OPPORTUNITES FOR THE RETARDED, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATION OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ANN
Authorized Official - Middle Name:K
Authorized Official - Last Name:HIGA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-622-3929
Mailing Address - Street 1:64-1488 KAMEHAMEHA HWY
Mailing Address - Street 2:
Mailing Address - City:WAHIAWA
Mailing Address - State:HI
Mailing Address - Zip Code:96786-2913
Mailing Address - Country:US
Mailing Address - Phone:808-622-3929
Mailing Address - Fax:
Practice Address - Street 1:64-1488 KAMEHAMEHA HWY
Practice Address - Street 2:
Practice Address - City:WAHIAWA
Practice Address - State:HI
Practice Address - Zip Code:96786-2913
Practice Address - Country:US
Practice Address - Phone:808-622-3929
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-13
Last Update Date:2009-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI504812-01Medicaid