NPI 1174720072

Hale Kokua, INC.

Organisation Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility San Mateo, CA

Practice location

Address: 516 Ocean View Ave, San Mateo, CA 94401-3029
Phone: (650) 347-1164
Mailing address: 1433 Dakota Avenue, San Mateo, CA 94401

Authorised official

Name: Pureza A. Ganio
Title: Licensee
Phone: (650) 520-5545

Registered specialties

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320900000X Licence 220000319 (CA)

Other Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities providers in California →

Registry record

NPI: 1174720072
Entity type: Organization
NPI issued: 2 Jul 2007
Record last updated: 21 Jan 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.