Healthcare Provider Details

I. General information

NPI: 1598765414
Provider Name (Legal Business Name): LEKI, INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2005
Last Update Date: 11/21/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

469 ENA RD 2301
HONOLULU HI
96815-1749
US

IV. Provider business mailing address

PO BOX 75688
HONOLULU HI
96836-0688
US

V. Phone/Fax

Practice location:
  • Phone: 808-949-7593
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License Number6-ICF
License Number StateHI

VIII. Authorized Official

Name: MRS. ALICE KIM LEW
Title or Position: ADMINISTRATOR
Credential: NHA-8
Phone: 808-949-7593