Healthcare Provider Details

I. General information

NPI: 1821708397
Provider Name (Legal Business Name): HALE NANI REHAB & NURSING CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/25/2022
Last Update Date: 01/02/2025
Certification Date: 01/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1677 PENSACOLA ST
HONOLULU HI
96822-2676
US

IV. Provider business mailing address

10401 LINN STATION RD STE 300
LOUISVILLE KY
40223-3825
US

V. Phone/Fax

Practice location:
  • Phone: 808-537-3371
  • Fax:
Mailing address:
  • Phone: 270-336-1050
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: DONALD J. KNOX
Title or Position: CEO
Credential:
Phone: 740-359-5401