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General NPI Number Information
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NPI Number | 1013446152
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Entity Type | Organization
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Legal Business Name | HAVEN CASE MANAGEMENT
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Dates
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Enumeration Date | 06/11/2017
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Last Update Date | 06/15/2017
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Provider Practice Location Address
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Address Line | 3418 LIKINI ST
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City | HONOLULU
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State | HI
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Zip | 96818-2103
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Country | US
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Telephone | 808-343-3472
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Fax |
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Provider Business Mailing Address
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Address Line | 3418 LIKINI ST
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City | HONOLULU
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State | HI
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Zip | 96818-2103
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Country | US
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Telephone | 808-351-8396
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Fax |
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Authorized Official
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Title or Position | REGISTERED NURSE
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Name | JED ASUNCION
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Credential | RN
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Telephone | 808-343-3472
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | 47
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License Number State | HI
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