Provider Demographics
NPI:1073872974
Name:MANOA ELDER CARE, L.L.C.
Entity Type:Organization
Organization Name:MANOA ELDER CARE, L.L.C.
Other - Org Name:MANOA SENIOR CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:M
Authorized Official - Last Name:DOLD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-440-0560
Mailing Address - Street 1:918 12TH AVENUE
Mailing Address - Street 2:SUITE 1000
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96816
Mailing Address - Country:US
Mailing Address - Phone:808-440-0560
Mailing Address - Fax:808-531-8865
Practice Address - Street 1:2240 OAHU AVE
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96822-2209
Practice Address - Country:US
Practice Address - Phone:808-952-6411
Practice Address - Fax:808-952-6511
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-11
Last Update Date:2012-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIOHCA#1262-C311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home