MEDICARE: LEKI, INCORPORATED

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	313M00000X	Nursing Facility/Intermediate Care Facility	6-ICF	HI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1598765414
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LEKI, INCORPORATED

Provider Business Mailing Address
First Line	:	PO BOX 75688
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96836-0688
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	469 ENA RD
Second Line	:	2301
City	:	HONOLULU
State	:	HI
Zip	:	96815-1749
Country	:	US
Telephone Number	:	808-949-7593
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MRS. ALICE KIM LEW
Credential	:	NHA-8
Telephone Number	:	808-949-7593

Provider Enumeration Date	:	07/21/2005
Last Update Date	:	11/21/2013

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Directions to “LEKI, INCORPORATED ” Practice Location

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