Healthcare Provider Details

I. General information

NPI: 1861868960
Provider Name (Legal Business Name): MALAMA ADULT DAY CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2015
Last Update Date: 08/12/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1208 ARTESIAN ST
HONOLULU HI
96826-1318
US

IV. Provider business mailing address

1208 ARTESIAN ST
HONOLULU HI
96826-1318
US

V. Phone/Fax

Practice location:
  • Phone: 808-946-9672
  • Fax: 808-955-4181
Mailing address:
  • Phone: 808-946-9672
  • Fax: 808-955-4181

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number1-1013
License Number StateHI

VIII. Authorized Official

Name: CYNTHIA YOSHIDA
Title or Position: CFO
Credential:
Phone: 808-687-3224