NPIMap

Organization Active NPI

TLC Wellness Hawaii, LLC

  • Nursing Care Agency
  • Honolulu, HI
National Provider Identifier
1407431596
Registry record updated Mar 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Care AgencyTaxonomy code 251J00000X
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
Mar 10, 2021
Last updated
Mar 10, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
TLC WELLNESS HAWAII, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 10, 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
Nursing Care Agency 251J00000X NU 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
Part of
TLC Wellness Hawaii LLC

Other organizations with this tax ID 1

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

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1615334400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615334400000",
    "number": "1407431596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 ATKINSON DR.",
            "address_2": "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.",
            "address_2": "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": "YES",
        "parent_organization_legal_business_name": "TLC WELLNESS HAWAII, LLC",
        "enumeration_date": "2021-03-10",
        "last_updated": "2021-03-10",
        "certification_date": "2021-03-10",
        "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": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "NU",
            "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 10, 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.