Provider Demographics
NPI:1639692361
Name:GARDEN ISLE CAREGIVERS
Entity Type:Organization
Organization Name:GARDEN ISLE CAREGIVERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATOR/CERTIFIED NURSE AID
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANNETTE
Authorized Official - Middle Name:FENIZA
Authorized Official - Last Name:RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-635-2338
Mailing Address - Street 1:5362 OLOPUA ST
Mailing Address - Street 2:
Mailing Address - City:KAPAA
Mailing Address - State:HI
Mailing Address - Zip Code:96746-2134
Mailing Address - Country:US
Mailing Address - Phone:808-635-2338
Mailing Address - Fax:808-212-1988
Practice Address - Street 1:5362 OLOPUA ST
Practice Address - Street 2:
Practice Address - City:KAPAA
Practice Address - State:HI
Practice Address - Zip Code:96746
Practice Address - Country:US
Practice Address - Phone:808-635-2338
Practice Address - Fax:808-212-1988
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253J00000XAgenciesFoster Care Agency