MEDICARE: FAITHCARE, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1164143194
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAITHCARE, LLC

Provider Business Mailing Address
First Line	:	1108 GULICK AVE
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96819-4513
Country	:	US
Telephone Number	:	808-312-4220
Fax Number	:	808-312-4220

Provider Business Practice Location Address
First Line	:	1108 GULICK AVE
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96819-4513
Country	:	US
Telephone Number	:	808-312-4220
Fax Number	:	808-312-4220

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	JUN LYNARD TOMAS TUGAS
Credential	:	RN
Telephone Number	:	808-799-5289

Provider Enumeration Date	:	09/07/2022
Last Update Date	:	01/12/2026

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