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General NPI Number Information
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NPI Number | 1104595214
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Entity Type | Organization
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Legal Business Name | MAKANA O KE AKUA, INC
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Dates
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Enumeration Date | 09/10/2021
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Last Update Date | 09/10/2021
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Provider Practice Location Address
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Address Line | 765 MCCULLY ST
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City | HONOLULU
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State | HI
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Zip | 96826-3916
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Country | US
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Telephone | 808-450-1327
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Fax | 808-425-4324
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Provider Business Mailing Address
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Address Line | 92-365 MALAHUNA PL
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City | KAPOLEI
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State | HI
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Zip | 96707-1654
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Country | US
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Telephone | 808-354-9823
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Fax | 808-691-9534
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS
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Name | MR. KEOKI DUDOIT
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Credential |
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Telephone | 808-354-9823
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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