Healthcare Provider Details
I. General information
NPI: 1891301016
Provider Name (Legal Business Name): MAIKA'I HEALTH CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/22/2020
Last Update Date: 08/01/2024
Certification Date: 08/01/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
740 KILAUEA AVE
HILO HI
96720
US
IV. Provider business mailing address
740 KILAUEA AVE
HILO HI
96720-4234
US
V. Phone/Fax
- Phone: 808-333-3420
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QC1500X |
| Taxonomy | Community Health Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
YOULSAU
BELLS
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 808-333-3420