1952447146 NPI number — HAWAII ISLAND ADULT CARE, INC.

Table of content: (NPI 1952447146)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952447146 NPI number — HAWAII ISLAND ADULT CARE, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HAWAII ISLAND ADULT CARE, 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:
1952447146
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/19/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
561 KUPUNA PL
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HILO
Provider Business Mailing Address State Name:
HI
Provider Business Mailing Address Postal Code:
96720-3935
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
808-961-3747
Provider Business Mailing Address Fax Number:
808-961-3740

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
34 RAINBOW DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HILO
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96720-2056
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-961-3747
Provider Business Practice Location Address Fax Number:
808-961-3740
Provider Enumeration Date:
01/29/2007

Additional Information

Authorized Official

Authorized Official Last Name:
SAQUING
Authorized Official First Name:
MARCIA
Authorized Official Middle Name:
A. K.
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
808-961-3747

Provider Taxonomy Codes

  • Taxonomy code: 251V00000X , with the licence number:  505399 , 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: 505399 . This is a "PROVIDER NUMBER" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".




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