Individual provider Active NPI

Helen M. Manzana, LICENSED CCFFHS

  • Adult Care Home Facility
  • Waipahu, HI
National Provider Identifier
1417772104
Registry record updated Nov 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Care Home FacilityTaxonomy code 311ZA0620X
Practice address
94-691 Kaaoki PL
Waipahu, HI 96797-1210
Phone
(808) 391-1164
NPI assigned
Nov 19, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Care Home Facility 311ZA0620X HI Primary

Addresses

Primary practice location

94-691 Kaaoki PL
Waipahu, HI 96797-1210

Mailing address

94-691 Kaaoki PL
Waipahu, HI 96797-1210
Phone (808) 391-1164

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1731974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731974400000",
    "number": "1417772104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "94-691 KAAOKI PL",
            "city": "WAIPAHU",
            "state": "HI",
            "postal_code": "967971210",
            "telephone_number": "808-391-1164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "94-691 KAAOKI PL",
            "city": "WAIPAHU",
            "state": "HI",
            "postal_code": "967971210",
            "telephone_number": "808-391-1164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANZANA",
        "first_name": "HELEN",
        "middle_name": "M.",
        "credential": "LICENSED CCFFHS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-11-19",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "HI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waipahu, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2024; 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.