Provider Demographics
NPI:1730499807
Name:RIINGEN RACCP FOSTER FAMILY HOME
Entity type:Organization
Organization Name:RIINGEN RACCP FOSTER FAMILY HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:BENITA
Authorized Official - Middle Name:VALDEZ
Authorized Official - Last Name:RIINGEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-982-3658
Mailing Address - Street 1:PO BOX 1766
Mailing Address - Street 2:
Mailing Address - City:KEAAU
Mailing Address - State:HI
Mailing Address - Zip Code:96749-1766
Mailing Address - Country:US
Mailing Address - Phone:808-982-3658
Mailing Address - Fax:808-982-3658
Practice Address - Street 1:17-559 IPUAIWAHA STREET
Practice Address - Street 2:
Practice Address - City:KEAAU
Practice Address - State:HI
Practice Address - Zip Code:96749
Practice Address - Country:US
Practice Address - Phone:808-982-3658
Practice Address - Fax:808-982-3658
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-07
Last Update Date:2010-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIW05576310-03311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home