WILSON HEALTHCARE, INC DBA HAWAIIAN HOUSE (NPI# 1871655191) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871655191 |
| Entity Type | Organization |
| Organization Name | WILSON HEALTHCARE, INC DBA HAWAIIAN HOUSE |
| Practice Address |
12440 224th St Hawaiian Gardens CA 90716-1718 |
| Mailing Address |
1027 Calle Juca Dr La Habra Heights CA 90631-8654 |
| Practice Telephone | 5624292616 |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MARK F. WILSON (ADMINISTRATOR) |
| Authorized Official Telephone | 5624292616 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | CA | Residential Treatment Facilities |
| Street Address |
12440 224TH ST |
| City | HAWAIIAN GARDENS |
| State | CA |
| Zip Code | 90716-1718 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053708081 | Pathway Medical Group | Specialist | 21500 S. Pioneer Blve Suite 210, Hawaiian Gardens, CA 90716 | 2015-04-16 |
| 1790032605 | Nancy Perez | Registered Nurse | 22009 Verne Ave, Hawaiian Gardens, CA 90716 | 2012-08-09 |
| 1194098210 | Ismael B. Nacino Md Inc | Anesthesiology | 21530 Pioneer Bl, Hawaiian Garden, CA 90716 | 2012-02-21 |
| 1326248832 | William Martin Wright | Counselor | 21520 S. Pioneer Blvd., Hawaiian Gardens, CA 90716 | 2007-07-23 |
| 1134341514 | Girish H Rami | Dentist | 12144 E Carson St, # E, Hawaiian Gardens, CA 90716 | 2007-05-03 |
| 1578684080 | Keun Chan Lee | Dentist | 12531 E Carson St, Hawaiian Gardens, CA 90716 | 2007-04-02 |
| 1154451995 | Consuelo Ramirez | Social Worker | 21520 S. Pioneer Bvld., Suite 110, Hawaiian Gardens, CA 90716 | 2007-03-07 |
| 1326102013 | Hyun Chan Lee | Dentist | 12137 E Carson St, Hawaiian Gardens, CA 90716 | 2006-12-20 |
| 1871656488 | Elena G Ezpeleta | Anesthesiology | 21530 South Pioneer Blvd, Hawaiian Gardens, CA 90716 | 2006-12-18 |
| 1144388687 | Jong Chul Han | Dentist | 11846 E Carson St, Hawaiian Gardens, CA 90716 | 2006-12-05 |
| Find all providers in zip 90716 | ||||
| Taxonomy Code | 320900000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
| A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619589959 | Mcnamar Residential | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2743 Lowell Dr, Chico, CA 95973-7216 | 2020-08-18 |
| 1386277747 | Trilogy Healthcare, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1989 Edgeview Dr, San Jose, CA 95122-4020 | 2020-02-13 |
| 1093257545 | Casa Edithafoundation Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1756 N Hill Ave, Pasadena, CA 91104-1429 | 2016-11-15 |
| 1336696046 | Mj Asset Services LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1315 W Merced Ave, West Covina, CA 91790-3904 | 2016-09-10 |
| 1639571599 | New Providence Care Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5167 G St, Chino, CA 91710-5143 | 2014-09-23 |
| 1427459700 | Good Samaritan Special Care Home | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 42612 35th St W, Lancaster, CA 93536-4105 | 2014-09-05 |
| 1699107581 | Arnon LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 8410 Springford Dr, Sun Valley, CA 91352-3648 | 2013-08-02 |
| 1790126423 | Contemporary Behavior Consultants, Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 8032 E Bynum St, Long Beach, CA 90808-3231 | 2013-07-10 |
| 1588002216 | Aacres Ca, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 19300 S. Hamilton Ave, Ste 130, Gardena, CA 90248 | 2013-06-04 |
| 1073868279 | Arnon LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 8410 Springford Drive, Sun Valley, CA 91352-3648 | 2012-07-13 |
| Find all providers with the same taxonomy | ||||
| City | HAWAIIAN GARDENS |
| Zip Code | 90716 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.