NPIMap

Organization Active NPI

TLC Wellness Hawaii, LLC

  • In Home Supportive Care Agency
  • Honolulu, HI
National Provider Identifier
1063005379
Registry record updated Mar 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
TLC WELLNESS HAWAII, LLC
Practice address
410 Atkinson Dr Ste 462
Honolulu, HI 96814-4730
Phone
(808) 200-1776
Fax
(808) 200-4013
NPI assigned
Feb 17, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Rosadelima Yutan Roslin
Title
Owner/Ceo
Phone
(808) 800-7886

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X Primary

Addresses

Primary practice location

410 Atkinson Dr Ste 462
Honolulu, HI 96814-4730

Mailing address

410 Atkinson Dr Ste 462
Honolulu, HI 96814-4730
Phone (808) 200-1776

Other identifiers 1

IdentifierTypeStateIssuer
818073MedicaidHI

National Provider Directory

National Provider Directory
Tax ID family
TLC Wellness Hawaii LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

410 Atkinson Dr
Ste 462
Honolulu, HI 96814
Phone (808) 200-1776

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1613520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615248000000",
    "number": "1063005379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 ATKINSON DR STE 462",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968144730",
            "telephone_number": "808-200-1776",
            "fax_number": "808-200-4013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 ATKINSON DR STE 462",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968144730",
            "telephone_number": "808-200-1776",
            "fax_number": "808-200-4013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TLC WELLNESS HAWAII, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-17",
        "last_updated": "2021-03-09",
        "certification_date": "2021-03-09",
        "status": "A",
        "authorized_official_last_name": "ROSLIN",
        "authorized_official_first_name": "ROSADELIMA",
        "authorized_official_middle_name": "YUTAN",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "808-800-7886"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "818073",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.