Provider Demographics
NPI:1972282663
Name:LACAMBRA CASE MANAGEMENT AGENCY
Entity Type:Organization
Organization Name:LACAMBRA CASE MANAGEMENT AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/RN CM LEAD
Authorized Official - Prefix:MS
Authorized Official - First Name:AYNES
Authorized Official - Middle Name:LAFORTEZA
Authorized Official - Last Name:LACAMBRA
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:917-597-9461
Mailing Address - Street 1:91-944 MAILANI ST
Mailing Address - Street 2:
Mailing Address - City:EWA BEACH
Mailing Address - State:HI
Mailing Address - Zip Code:96706-2255
Mailing Address - Country:US
Mailing Address - Phone:917-597-9461
Mailing Address - Fax:808-379-1051
Practice Address - Street 1:91-944 MAILANI ST
Practice Address - Street 2:
Practice Address - City:EWA BEACH
Practice Address - State:HI
Practice Address - Zip Code:96706-2255
Practice Address - Country:US
Practice Address - Phone:917-597-9461
Practice Address - Fax:808-379-1051
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-12
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management