Provider Demographics
NPI:1356707541
Name:DOLOR ENTERPRISES LLC
Entity type:Organization
Organization Name:DOLOR ENTERPRISES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:GRACE
Authorized Official - Middle Name:RAMISCAL
Authorized Official - Last Name:DOLOR
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:808-436-2183
Mailing Address - Street 1:45-216 MAKAHIO ST
Mailing Address - Street 2:
Mailing Address - City:KANEOHE
Mailing Address - State:HI
Mailing Address - Zip Code:96744-3119
Mailing Address - Country:US
Mailing Address - Phone:808-347-2536
Mailing Address - Fax:
Practice Address - Street 1:45-216 MAKAHIO ST
Practice Address - Street 2:
Practice Address - City:KANEOHE
Practice Address - State:HI
Practice Address - Zip Code:96744-3119
Practice Address - Country:US
Practice Address - Phone:808-347-2536
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-05
Last Update Date:2016-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIRN-57042310500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310500000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Mental Illness