Healthcare Provider Details

I. General information

NPI: 1861488553
Provider Name (Legal Business Name): FAMILY HEALTH II, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2005
Last Update Date: 12/09/2020
Certification Date: 12/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1814 LILIHA ST
HONOLULU HI
96817-2324
US

IV. Provider business mailing address

1814 LILIHA ST
HONOLULU HI
96817-2324
US

V. Phone/Fax

Practice location:
  • Phone: 808-537-9557
  • Fax: 808-599-4722
Mailing address:
  • Phone: 808-748-8701
  • Fax: 808-599-4722

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number47-N
License Number StateHI

VIII. Authorized Official

Name: EDISON K MIYAWAKI
Title or Position: PRESIDENT
Credential: MD
Phone: 808-537-9557