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General NPI Number Information
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NPI Number | 1902127715
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Entity Type | Organization
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Legal Business Name | DAJ HEALTHCARE AND HOMECARE AGENCY LLC
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Dates
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Enumeration Date | 06/15/2010
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Last Update Date | 06/15/2010
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Provider Practice Location Address
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Address Line | 721 MCCULLY ST
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City | HONOLULU
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State | HI
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Zip | 96826-3903
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Country | US
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Telephone | 808-343-5522
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Fax |
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Provider Business Mailing Address
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Address Line | 721 MCCULLY ST
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City | HONOLULU
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State | HI
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Zip | 96826-3903
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Country | US
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Telephone | 808-343-5522
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | DENISSE DE JESUS JOSON
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Credential | M.A., C.N.A
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Telephone | 808-343-5522
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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 | W0547257601
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License Number State | HI
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