Provider Demographics
NPI:1114127859
Name:ALII COMMUNITY CARE, INC
Entity Type:Organization
Organization Name:ALII COMMUNITY CARE, INC
Other - Org Name:ALII HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:REGIONAL CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-988-4430
Mailing Address - Street 1:79-1019 HAUKAPILA ST
Mailing Address - Street 2:
Mailing Address - City:KEALAKEKUA
Mailing Address - State:HI
Mailing Address - Zip Code:96750-7920
Mailing Address - Country:US
Mailing Address - Phone:808-322-6980
Mailing Address - Fax:
Practice Address - Street 1:75-5995 KUAKINI HWY STE 213
Practice Address - Street 2:
Practice Address - City:KAILUA KONA
Practice Address - State:HI
Practice Address - Zip Code:96740-2120
Practice Address - Country:US
Practice Address - Phone:808-329-1172
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-20
Last Update Date:2007-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty