| Preferred Home & Community Based Services, Inc. | |
|
94-412 Maikoiko Street Waipahu HI 96797 | |
| (808) 456-0078 | |
| Not Available |
| Full Name | Preferred Home & Community Based Services, Inc. |
|---|---|
| Speciality | Day Training, Developmentally Disabled Services |
| Location | 94-412 Maikoiko Street, Waipahu, Hawaii |
| Authorized Official Name and Position | Maria A.f. Etrata (PRESIDENT/CEO) |
| Authorized Official Contact | 8084560078 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Preferred Home & Community Based Services, Inc. 94-412 Maikoiko Street Waipahu HI 96797-0000 Ph: (808) 456-0078 | Preferred Home & Community Based Services, Inc. 94-412 Maikoiko Street Waipahu HI 96797 Ph: (808) 456-0078 |
| NPI Number | 1538438544 |
|---|---|
| Provider Enumeration Date | 12/20/2011 |
| Last Update Date | 04/14/2021 |
| Certification Date | 04/14/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538438544 | NPI | - | NPPES |
| 540246 | Other | HI | STATE OF HAWAII DEVELOPMENTA DISABILITIES MEDICAID WAIVER PROGRAM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 251S00000NX (Hawaii) | Secondary |
| 251C00000X | Day Training, Developmentally Disabled Services | (* (Not Available)) | Primary |
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