=====================================================
General NPI Number Information
=====================================================
NPI Number | 1366108201
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ALOHA ADULT CARE LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/15/2021
-----------------------------------------------------
Last Update Date | 11/15/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1193 ALA NAPUNANI ST
-----------------------------------------------------
City | HONOLULU
-----------------------------------------------------
State | HI
-----------------------------------------------------
Zip | 96818-1613
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 808-393-7000
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1193 ALA NAPUNANI ST
-----------------------------------------------------
City | HONOLULU
-----------------------------------------------------
State | HI
-----------------------------------------------------
Zip | 96818-1613
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 808-393-7000
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | ANNABELLE HUNG
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 808-393-7000
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QA0600X
-----------------------------------------------------
Taxonomy Name | Adult Day Care Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------