Organization Active NPI

O'Hana Heritage Foundation Inc

Doing business as A Rosie Place

  • Special Hospital
  • South Bend, IN
National Provider Identifier
1720374374
Registry record updated Oct 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Special HospitalTaxonomy code 284300000X
License
11-012157-1 Issued in IN
Legal business name
O'HANA HERITAGE FOUNDATION INC
Doing business as
A Rosie Place
Practice address
53131 Quince Rd
South Bend, IN 46628-9691
Phone
(574) 235-8899
Fax
(574) 235-8897
NPI assigned
Jun 22, 2011
Last updated
Oct 23, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2015

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

Authorized official

Name
Tieal C. Bishop
Title
Executive Director/Ceo
Phone
(574) 315-6283

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Special Hospital 284300000X 11-012157-1 IN Primary

Addresses

Primary practice location

53131 Quince Rd
South Bend, IN 46628-9691

Mailing address

53131 Quince Rd
South Bend, IN 46628-9691
Phone (574) 235-8899

Other names 1

  • A Rosie Place Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
15D2008816A Rosie Place53131 Quince Rd, South Bend, IN 46628Certificate of waiverJun 17, 2028

National Provider Directory

National Provider Directory

Locations

53131 Quince Rd
South Bend, IN 46628
Phone (574) 235-8899

NPI Registry JSON

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

{
    "created_epoch": "1308700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445558400000",
    "number": "1720374374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53131 QUINCE RD",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466289691",
            "telephone_number": "574-235-8899",
            "fax_number": "574-235-8897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "53131 QUINCE RD",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466289691",
            "telephone_number": "574-235-8899",
            "fax_number": "574-235-8897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "O'HANA HERITAGE FOUNDATION INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-22",
        "last_updated": "2015-10-23",
        "status": "A",
        "authorized_official_last_name": "BISHOP",
        "authorized_official_first_name": "TIEAL",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR/CEO",
        "authorized_official_telephone_number": "574-315-6283"
    },
    "taxonomies": [
        {
            "code": "284300000X",
            "taxonomy_group": "",
            "desc": "Special Hospital",
            "state": "IN",
            "license": "11-012157-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "A Rosie Place",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in South Bend, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.