Healthcare Provider Details

I. General information

NPI: 1063481794
Provider Name (Legal Business Name): HAWAII PROFESSIONALS HOMECARE SERVICES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/15/2006
Last Update Date: 07/26/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

377 KEAHOLE STREET SUITE E106
HONOLULU HI
96825-3412
US

IV. Provider business mailing address

377 KEAHOLE STREET SUITE E106
HONOLULU HI
96825-3412
US

V. Phone/Fax

Practice location:
  • Phone: 808-396-2160
  • Fax: 808-396-2161
Mailing address:
  • Phone: 808-396-2160
  • Fax: 808-396-2161

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHHA35
License Number StateHI

VIII. Authorized Official

Name: MS. CAROLYN FRUTOZ-DEHARNE
Title or Position: CEO
Credential: RN
Phone: 808-245-7211