Healthcare Provider Details

I. General information

NPI: 1780953398
Provider Name (Legal Business Name): HAWAII HEALTH SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/28/2011
Last Update Date: 12/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

94-422 UKE'E STREET, BAY 1
WAIPAHU HI
96797
US

IV. Provider business mailing address

94-422 UKE'E STREET, BAY 1
WAIPAHU HI
96797
US

V. Phone/Fax

Practice location:
  • Phone: 808-680-0103
  • Fax: 808-680-0105
Mailing address:
  • Phone: 808-680-0103
  • Fax: 808-680-0105

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number516924.01
License Number StateHI
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. ALELI N. YOSHIDA
Title or Position: MANAGER
Credential: SECRETARY
Phone: 808-680-0103