Healthcare Provider Details

I. General information

NPI: 1568881894
Provider Name (Legal Business Name): AMERICARE HAWAII, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/15/2014
Last Update Date: 04/15/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

283 LALO ST STE 220
KAHULUI HI
96732-2928
US

IV. Provider business mailing address

283 LALO ST STE 220
KAHULUI HI
96732-2928
US

V. Phone/Fax

Practice location:
  • Phone: 808-893-2152
  • Fax: 808-893-2153
Mailing address:
  • Phone: 808-893-2152
  • Fax: 808-893-2153

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number1853725-01
License Number StateHI

VIII. Authorized Official

Name: MS. MINERVA PURUGGANAN BORJA
Title or Position: OPERATION MANAGER
Credential:
Phone: 808-214-8666