Healthcare Provider Details

I. General information

NPI: 1245654870
Provider Name (Legal Business Name): MUKAI, JOYCE R.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/18/2014
Last Update Date: 02/18/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2465 ALA WAI BLVD APT 904
HONOLULU HI
96815-3432
US

IV. Provider business mailing address

2465 ALA WAI BLVD APT 904
HONOLULU HI
96815-3432
US

V. Phone/Fax

Practice location:
  • Phone: 808-783-8807
  • Fax:
Mailing address:
  • Phone: 808-783-8807
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3104A0625X
TaxonomyAssisted Living Facility (Mental Illness)
License Number
License Number State

VIII. Authorized Official

Name: JOYCE MUKAI
Title or Position: OWNER
Credential:
Phone: 808-783-8807