Organization
OHANAS CONNECTION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANTESE HILLS (OWNER)
(252) 503-1879
Entity
Organization
Contact information
Practice address
413 S GLANCY ST, SWANSBORO, NC 28584-9656
(252) 503-1879
Mailing address
334 SONOMA RD, JACKSONVILLE, NC 28546-8405
(252) 503-1879
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
343900000X
Non-emergency Medical Transport (VAN)
—
—
347C00000X
Private Vehicle
—
—
385H00000X
Respite Care
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
320800000X
—
NC
05
—
320900000X
—
NC
05
—
385H00000X
—
NC
Enumeration date
12/05/2022
Last updated
06/04/2023
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