Provider Demographics
NPI:1477389930
Name:KINA'OLE HOME HEALTH CARE LLC
Entity type:Organization
Organization Name:KINA'OLE HOME HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:VICTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:858-254-0339
Mailing Address - Street 1:9672 VIA EXCELENCIA STE 103
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92126-4573
Mailing Address - Country:US
Mailing Address - Phone:858-254-0339
Mailing Address - Fax:
Practice Address - Street 1:91-110 HANUA ST STE 203
Practice Address - Street 2:
Practice Address - City:KAPOLEI
Practice Address - State:HI
Practice Address - Zip Code:96707-1702
Practice Address - Country:US
Practice Address - Phone:808-460-3166
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-11
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health