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General NPI Number Information
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NPI Number | 1417352063
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Entity Type | Organization
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Legal Business Name | HI'ILANI HEALTH CORPORATION
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Dates
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Enumeration Date | 10/24/2014
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Last Update Date | 04/17/2015
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Provider Practice Location Address
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Address Line | 108 OLOKANI PLACE 2ND FLOOR
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City | WAHIAWA
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State | HI
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Zip | 96786
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Country | US
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Telephone | 808-497-8157
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Fax |
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Provider Business Mailing Address
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Address Line | 108 OLOKANI PL 2ND FLOOR
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City | WAHIAWA
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State | HI
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Zip | 96786-4812
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Country | US
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Telephone | 808-497-8157
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Fax |
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Authorized Official
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Title or Position | CORPORATE OFFICER/PRESIDENT
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Name | MR. JAY RAYMUNDO
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Credential |
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Telephone | 808-497-8157
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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