Healthcare Provider Details

I. General information

NPI: 1902455462
Provider Name (Legal Business Name): LAULEA CASE MANAGEMENT AGENCY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/07/2019
Last Update Date: 09/07/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1468 MELE MANU ST
HILO HI
96720-1794
US

IV. Provider business mailing address

1468 MELE MANU ST
HILO HI
96720-1794
US

V. Phone/Fax

Practice location:
  • Phone: 808-796-3408
  • Fax: 808-796-3022
Mailing address:
  • Phone: 808-796-3408
  • Fax: 808-796-3022

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. NOEMI ARZAGA
Title or Position: CEO, ADMINISTRATOR
Credential: DNP, FNP-BC
Phone: 808-796-3408