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General NPI Number Information
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NPI Number | 1144301383
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Entity Type | Organization
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Legal Business Name | BLUE WATER RESOURCES
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Dates
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Enumeration Date | 10/17/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 94-229 WAIPAHU DEPOT ROAD SUITE 401
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City | WAIPAHU
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State | HI
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Zip | 96797-3031
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Country | US
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Telephone | 808-678-3661
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Fax | 808-678-3662
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Provider Business Mailing Address
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Address Line | 94-229 WAIPAHU DEPOT ROAD SUITE 401
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City | WAIPAHU
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State | HI
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Zip | 96797-3031
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Country | US
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Telephone | 808-678-3661
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Fax | 808-678-3662
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Authorized Official
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Title or Position | CO-OWNER
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Name | MRS. SARAH SUZUKI
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Credential | R.N., B.S.N., M.B.A
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Telephone | 808-678-3661
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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 |
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License Number State | HI
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