Provider Demographics
NPI:1659049864
Name:MARIANAS HOME CARE SERVICES
Entity Type:Organization
Organization Name:MARIANAS HOME CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:LOUIE SCOTT
Authorized Official - Middle Name:FLORES
Authorized Official - Last Name:ATIENZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-495-2304
Mailing Address - Street 1:232 KAIULANI AVE
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96815-3063
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:232 KAIULANI AVE
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96815-3063
Practice Address - Country:US
Practice Address - Phone:206-495-2304
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-01
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health