Organization
MARY JEAN B. URSUA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARY JEAN BARBADO URSUA CAREGIVER (LPN)
(808) 877-0351
Entity
Organization
Contact information
Practice address
383 W PAPA AVE, KAHULUI, HI 96732-2639
(808) 877-0351
(808) 877-0351
Mailing address
383 W PAPA AVE, KAHULUI, HI 96732-2639
(808) 877-0351
(808) 877-0351
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
W03609234-01
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
587785
—
HI
05
—
W03609234-01
—
HI
Enumeration date
11/01/2009
Last updated
11/01/2009
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