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General NPI Number Information
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NPI Number | 1730330614
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Entity Type | Organization
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Legal Business Name | KONA ADULT DAY CENTER, INC.
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Dates
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Enumeration Date | 10/09/2008
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Last Update Date | 10/09/2008
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Provider Practice Location Address
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Address Line | 81989 HALEKII STREET
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City | KEALAKEKUA
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State | HI
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Zip | 96750
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Country | US
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Telephone | 808-322-7977
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Fax | 808-322-0614
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Provider Business Mailing Address
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Address Line | PO BOX 1360
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City | KEALAKEKUA
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State | HI
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Zip | 96750-1360
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Country | US
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Telephone | 808-322-7922
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Fax | 808-322-0614
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MS. ROWENA L. TIQUI
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Credential |
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Telephone | 808-322-7977
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number | 385H00000X
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License Number State | HI
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