1205108461 NPI number — HALE NUI COMMUNITY SERVICES, INC.

Table of content: (NPI 1205108461)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1205108461 NPI number — HALE NUI COMMUNITY SERVICES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HALE NUI COMMUNITY SERVICES, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1205108461
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/03/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1160
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WAIALUA
Provider Business Mailing Address State Name:
HI
Provider Business Mailing Address Postal Code:
96791-1160
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
808-637-2646
Provider Business Mailing Address Fax Number:
808-637-4577

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
67-292 GOODALE AVE
Provider Second Line Business Practice Location Address:
#A6
Provider Business Practice Location Address City Name:
WAIALUA
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96791-9664
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-637-2464
Provider Business Practice Location Address Fax Number:
808-637-4577
Provider Enumeration Date:
02/03/2012

Additional Information

Authorized Official

Authorized Official Last Name:
ULEP
Authorized Official First Name:
MARCELLE
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
808-223-8840

Provider Taxonomy Codes

  • Taxonomy code: 251C00000X , with the licence number:  00543092 , registered in the state of HI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 00543092 , issued by the state of ( HI ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com