Provider Demographics
NPI:1174947790
Name:JORNACION, ROMERA A. DBA ALOHA LIFELINE
Entity type:Organization
Organization Name:JORNACION, ROMERA A. DBA ALOHA LIFELINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROMERA
Authorized Official - Middle Name:
Authorized Official - Last Name:JORNACION
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-689-5031
Mailing Address - Street 1:91-983 IKULANI ST
Mailing Address - Street 2:
Mailing Address - City:EWA BEACH
Mailing Address - State:HI
Mailing Address - Zip Code:96706-2207
Mailing Address - Country:US
Mailing Address - Phone:808-689-5031
Mailing Address - Fax:
Practice Address - Street 1:91-983 IKULANI ST
Practice Address - Street 2:
Practice Address - City:EWA BEACH
Practice Address - State:HI
Practice Address - Zip Code:96706-2207
Practice Address - Country:US
Practice Address - Phone:808-689-5031
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-18
Last Update Date:2014-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness