Provider Demographics
NPI:1720374374
Name:O'HANA HERITAGE FOUNDATION INC
Entity Type:Organization
Organization Name:O'HANA HERITAGE FOUNDATION INC
Other - Org Name:A ROSIE PLACE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR/CEO
Authorized Official - Prefix:
Authorized Official - First Name:TIEAL
Authorized Official - Middle Name:C
Authorized Official - Last Name:BISHOP
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:574-315-6283
Mailing Address - Street 1:53131 QUINCE RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH BEND
Mailing Address - State:IN
Mailing Address - Zip Code:46628-9691
Mailing Address - Country:US
Mailing Address - Phone:574-235-8899
Mailing Address - Fax:574-235-8897
Practice Address - Street 1:53131 QUINCE RD
Practice Address - Street 2:
Practice Address - City:SOUTH BEND
Practice Address - State:IN
Practice Address - Zip Code:46628-9691
Practice Address - Country:US
Practice Address - Phone:574-235-8899
Practice Address - Fax:574-235-8897
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-22
Last Update Date:2015-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN11-012157-1284300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes284300000XHospitalsSpecial Hospital