Wilson Healthcare, Inc Dba Hawaiian House

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

WILSON HEALTHCARE, INC DBA HAWAIIAN HOUSE

Practice address

12440 224TH St
Hawaiian Gardens, CA 90716-1718

Phone

(562) 429-2616

NPI assigned

Dec 14, 2006

Organization subpart

No

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

Authorized official

Name

Mark F. Wilson

Title

Administrator

Phone

(562) 429-2616

Specialties & licenses 1

Addresses

Tax ID family

Wilson Healthcare Inc Dba Hawaiian House2 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.

• Wilson Healthcare, Inc Dba Sierra House

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Lakewood, CA
  • NPI 1437211760
  NPD tax ID

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1871655191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1027 CALLE JUCA DR",
            "city": "LA HABRA HEIGHTS",
            "state": "CA",
            "postal_code": "906318654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12440 224TH ST",
            "city": "HAWAIIAN GARDENS",
            "state": "CA",
            "postal_code": "907161718",
            "telephone_number": "562-429-2616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILSON HEALTHCARE, INC DBA HAWAIIAN HOUSE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "F.",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "562-429-2616"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Hawaiian Gardens, CA
• Providers in Hawaiian Gardens, CA by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.