Healthcare Provider Details

I. General information

NPI: 1295280865
Provider Name (Legal Business Name): HO'OKELE CAREGIVERS MAUI,LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/23/2016
Last Update Date: 08/23/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1345 S BERETANIA ST STE 304
HONOLULU HI
96814-1802
US

IV. Provider business mailing address

1345 S BERETANIA ST STE 304
HONOLULU HI
96814-1802
US

V. Phone/Fax

Practice location:
  • Phone: 808-457-1657
  • Fax: 808-535-1547
Mailing address:
  • Phone: 808-457-1657
  • Fax: 808-535-1547

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License NumberW04186022-01
License Number StateHI

VIII. Authorized Official

Name: MARY LESTER
Title or Position: COO
Credential: RN
Phone: 808-385-1202