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General NPI Number Information
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NPI Number | 1770570780
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Entity Type | Organization
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Legal Business Name | MOLOKAI OHANA HEALTH CARE, INC.
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Dates
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Enumeration Date | 10/04/2005
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Last Update Date | 11/02/2021
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Provider Practice Location Address
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Address Line | 30 OKI PLACE
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City | KAUNAKAKAI
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State | HI
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Zip | 96748-2040
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Country | US
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Telephone | 808-553-5038
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2040
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City | KAUNAKAKAI
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State | HI
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Zip | 96748-2040
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Country | US
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Telephone | 808-553-5038
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Fax |
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | HELEN KEKALIA
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Credential |
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Telephone | 808-660-2601
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State | HI
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Taxonomy #2
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State |
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