=====================================================
General NPI Number Information
=====================================================
NPI Number | 1457394074
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | WEST HAWAII HOME HEALTH SERVICES, INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/13/2006
-----------------------------------------------------
Last Update Date | 03/17/2018
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 81-990 HALEKII ST UNIT 100
-----------------------------------------------------
City | KEALAKEKUA
-----------------------------------------------------
State | HI
-----------------------------------------------------
Zip | 96750-5006
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 808-328-9883
-----------------------------------------------------
Fax | 808-328-8052
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 81-990 HALEKII STREET UNIT 100
-----------------------------------------------------
City | KEALAKEKUA
-----------------------------------------------------
State | HI
-----------------------------------------------------
Zip | 96750-0291
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 808-328-9883
-----------------------------------------------------
Fax | 808-328-8052
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | JOHN M CHAVEZ
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 408-470-0042
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | HHA-33
-----------------------------------------------------
License Number State | HI
-----------------------------------------------------