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General NPI Number Information
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NPI Number | 1922151026
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Entity Type | Organization
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Legal Business Name | PO AILANI
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Dates
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Enumeration Date | 01/19/2007
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Last Update Date | 10/19/2018
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Provider Practice Location Address
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Address Line | 45-567 PAHIA ROAD
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City | KANEOHE
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State | HI
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Zip | 96744
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Country | US
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Telephone | 808-263-3500
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Fax | 808-263-3508
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Provider Business Mailing Address
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Address Line | 45-567 PAHIA ROAD
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City | KANEOHE
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State | HI
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Zip | 96744
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Country | US
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Telephone | 808-263-3500
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Fax | 808-263-3508
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Authorized Official
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Title or Position | CEO
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Name | MRS. JANET R PAREDES
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Credential |
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Telephone | 808-263-3500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number | W20316842-01
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License Number State | HI
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Taxonomy #2
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number |
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License Number State |
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