Healthcare Provider Details

I. General information

NPI: 1447901657
Provider Name (Legal Business Name): STAY AT HOME HEALTHCARE SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2022
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

563 KAUMANA DR STE U
HILO HI
96720-1812
US

IV. Provider business mailing address

45-181 WAIKALUA RD
KANEOHE HI
96744-2765
US

V. Phone/Fax

Practice location:
  • Phone: 808-900-7232
  • Fax: 808-865-2444
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: RANDALL I HATA
Title or Position: VP
Credential:
Phone: 808-791-4496