Healthcare Provider Details

I. General information

NPI: 1831427608
Provider Name (Legal Business Name): ALOHA HABILITATION SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2009
Last Update Date: 03/09/2021
Certification Date: 03/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 KAHELU AVENUE SUITE 231
MILILANI HI
96789-3962
US

IV. Provider business mailing address

100 KAHELU AVENUE SUITE 231
MILILANI HI
96789-3962
US

V. Phone/Fax

Practice location:
  • Phone: 808-622-4200
  • Fax: 808-622-4211
Mailing address:
  • Phone: 808-622-4200
  • Fax: 808-622-4211

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 Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateHI

VIII. Authorized Official

Name: MR. JAY RAYMUNDO
Title or Position: CEO/SECRETARY
Credential:
Phone: 808-497-8157