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General NPI Number Information
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NPI Number | 1548565641
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Entity Type | Organization
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Legal Business Name | ALII COMMUNITY CARE, INC.
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Dates
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Enumeration Date | 01/20/2011
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Last Update Date | 04/08/2011
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Provider Practice Location Address
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Address Line | 77-6443 KUAKINI HWY
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City | KAILUA KONA
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State | HI
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Zip | 96740-2227
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Country | US
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Telephone | 808-334-0900
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Fax | 808-334-0930
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Provider Business Mailing Address
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Address Line | 75-5759 KUAKINI HWY SUITE 208
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City | KAILUA KONA
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State | HI
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Zip | 96740-1726
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Country | US
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Telephone | 808-331-0777
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Fax | 808-331-8682
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | DEBRA SUNDBERG
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Credential |
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Telephone | 808-331-0777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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