Healthcare Provider Details

I. General information

NPI: 1033436431
Provider Name (Legal Business Name): ALOHAWELLNESS CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2010
Last Update Date: 04/23/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

94-1388 MOANIANI ST STE 203
WAIPAHU HI
96797-6604
US

IV. Provider business mailing address

94-1388 MOANIANI ST STE 203
WAIPAHU HI
96797-6604
US

V. Phone/Fax

Practice location:
  • Phone: 808-695-3570
  • Fax: 808-487-2492
Mailing address:
  • Phone: 808-695-3570
  • Fax: 808-487-2492

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number346-83
License Number StateHI

VIII. Authorized Official

Name: JOSE REQUE
Title or Position: BILLING MANAGER
Credential:
Phone: 808-531-7878