Organization
SMRTV FOSTER HOME,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHELLA MARIE TAGUDIN VALENCIA (PRESIDENT)
(808) 222-5485
Entity
Organization
Contact information
Practice address
94-470 OPEHA ST, WAIPAHU, HI 96797-4516
(808) 222-5485
Mailing address
94-470 OPEHA ST, WAIPAHU, HI 96797-4516
(808) 222-5485
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
—
—
Other
Enumeration date
02/03/2023
Last updated
02/03/2023
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