Preferred Home & Community Based Services, Inc.

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

Legal business name

PREFERRED HOME & COMMUNITY BASED SERVICES, INC.

Practice address

94-412 Maikoiko Street
Waipahu, HI 96797

Phone

(808) 456-0078

NPI assigned

Dec 20, 2011

Organization subpart

No

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

Authorized official

Name

Maria A.F. Etrata

Title

President/Ceo

Phone

(808) 456-0078

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1324339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618358400000",
    "number": "1538438544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "94-412 MAIKOIKO STREET",
            "city": "WAIPAHU",
            "state": "HI",
            "postal_code": "967970000",
            "telephone_number": "808-456-0078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "94-412 MAIKOIKO STREET",
            "city": "WAIPAHU",
            "state": "HI",
            "postal_code": "96797",
            "telephone_number": "808-456-0078"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "97-719 Kamehameha Highway, Suite B101",
            "address_purpose": "LOCATION",
            "city": "Pearl City",
            "state": "HI",
            "postal_code": "967820000",
            "country_code": "US",
            "telephone_number": "808-456-0078",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PREFERRED HOME & COMMUNITY BASED SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-20",
        "last_updated": "2021-04-14",
        "certification_date": "2021-04-14",
        "status": "A",
        "authorized_official_last_name": "ETRATA",
        "authorized_official_first_name": "MARIA",
        "authorized_official_middle_name": "A.F.",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "808-456-0078"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "HI",
            "license": "251S00000NX",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF HAWAII DEVELOPMENTA DISABILITIES MEDICAID WAIVER PROGRAM",
            "identifier": "540246",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Developmentally Disabled Services Day Training Agency in Waipahu, HI
• Providers in Waipahu, HI by specialty
• Developmentally Disabled Services Day Training Agency in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 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.