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Organization

PSH KM LLC

Active
Parent organization
PACIFIC SKILLED HEALTHCARE LLC
Organization subpart
Yes

Provider details

NPI number
Legal business name
PACIFIC SKILLED HEALTHCARE LLC
Authorized official
SPENCER OLSEN (OWNER)
(949) 521-0707
Entity
Organization

Contact information

Practice address
91-1360 KARAYAN ST, EWA BEACH, HI 96706-1985
(808) 681-1200
(808) 681-1238
Mailing address
919 LEHUA AVE, PEARL CITY, HI 96782-3328
(808) 687-3224
(808) 687-3209

Taxonomy

Speciality
Code
Description
License number
State
3140N1450X
Pediatric Skilled Nursing Facility
Primary

Other

Enumeration date
11/08/2022
Last updated
11/08/2022
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