Healthcare Provider Details

I. General information

NPI: 1730704586
Provider Name (Legal Business Name): LOKELANI 'OHANA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2020
Last Update Date: 02/14/2021
Certification Date: 02/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

295 MIKOHU LOOP
KAHULUI HI
96732-1129
US

IV. Provider business mailing address

PO BOX 2964
WAILUKU HI
96793-7964
US

V. Phone/Fax

Practice location:
  • Phone: 503-544-6592
  • Fax:
Mailing address:
  • Phone: 503-544-6592
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code320700000X
TaxonomyPhysical Disabilities Residential Treatment Facility
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number State

VIII. Authorized Official

Name: ANTONE J EEK
Title or Position: EXECUTIVE ADMINISTRATOR / TREASURER
Credential:
Phone: 503-544-6592