Provider Demographics
NPI:1538157847
Name:OWAKIHI INC
Entity type:Organization
Organization Name:OWAKIHI INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:J
Authorized Official - Last Name:MOHRBACHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:651-451-2889
Mailing Address - Street 1:201 CONCORD EXCHANGE N
Mailing Address - Street 2:
Mailing Address - City:SOUTH SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55075-1104
Mailing Address - Country:US
Mailing Address - Phone:651-451-2889
Mailing Address - Fax:651-451-5955
Practice Address - Street 1:201 CONCORD EXCHANGE N
Practice Address - Street 2:
Practice Address - City:SOUTH SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55075-1104
Practice Address - Country:US
Practice Address - Phone:651-451-2889
Practice Address - Fax:651-451-5955
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN8002603RS315P00000X
MN8024332RS315P00000X
261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities
Not Answered261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)