Healthcare Provider Details

I. General information

NPI: 1982930624
Provider Name (Legal Business Name): NORITA ELDERLY CERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/31/2009
Last Update Date: 10/31/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1884 MAKILA PL
WAILUKU HI
96793-2913
US

IV. Provider business mailing address

1884 MAKILA PL
WAILUKU HI
96793-2913
US

V. Phone/Fax

Practice location:
  • Phone: 808-633-4261
  • Fax: 808-633-4261
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License NumberW03607656-01
License Number StateHI

VIII. Authorized Official

Name: NORITA T MORRISON
Title or Position: CNA
Credential: CARE GIVER
Phone: 808-633-4261