Provider Demographics
NPI:1609187426
Name:EDITHA SORIA FOSTER HOME
Entity Type:Organization
Organization Name:EDITHA SORIA FOSTER HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CNA
Authorized Official - Prefix:MISS
Authorized Official - First Name:EDITHA
Authorized Official - Middle Name:PENGSON
Authorized Official - Last Name:SORIA
Authorized Official - Suffix:
Authorized Official - Credentials:FOSTER HOME OERATOR
Authorized Official - Phone:808-692-3140
Mailing Address - Street 1:94-1055 KUHAULUA ST
Mailing Address - Street 2:
Mailing Address - City:WAIPAHU
Mailing Address - State:HI
Mailing Address - Zip Code:96797-2851
Mailing Address - Country:US
Mailing Address - Phone:808-692-3140
Mailing Address - Fax:808-888-7605
Practice Address - Street 1:94-1055 KUHAULUA ST
Practice Address - Street 2:
Practice Address - City:WAIPAHU
Practice Address - State:HI
Practice Address - Zip Code:96797-2851
Practice Address - Country:US
Practice Address - Phone:808-692-3140
Practice Address - Fax:808-888-7605
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-25
Last Update Date:2010-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health