Healthcare Provider Details

I. General information

NPI: 1457394074
Provider Name (Legal Business Name): WEST HAWAII HOME HEALTH SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2006
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

81-990 HALEKII ST UNIT 100
KEALAKEKUA HI
96750-5006
US

IV. Provider business mailing address

81-990 HALEKII STREET UNIT 100
KEALAKEKUA HI
96750-0291
US

V. Phone/Fax

Practice location:
  • Phone: 808-328-9883
  • Fax: 808-328-8052
Mailing address:
  • Phone: 808-328-9883
  • Fax: 808-328-8052

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberHHA-33
License Number StateHI

VIII. Authorized Official

Name: JOHN M CHAVEZ
Title or Position: CEO
Credential:
Phone: 408-470-0042