Provider Demographics
NPI:1164143012
Name:IKE PONO CASE MANAGEMENT LLC
Entity Type:Organization
Organization Name:IKE PONO CASE MANAGEMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / DIRECTOR / CASE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:AULANI
Authorized Official - Last Name:FANENE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-397-4638
Mailing Address - Street 1:195 MULIWAI AVE
Mailing Address - Street 2:
Mailing Address - City:WAHIAWA
Mailing Address - State:HI
Mailing Address - Zip Code:96786-2013
Mailing Address - Country:US
Mailing Address - Phone:808-397-4638
Mailing Address - Fax:
Practice Address - Street 1:195 MULIWAI AVE
Practice Address - Street 2:
Practice Address - City:WAHIAWA
Practice Address - State:HI
Practice Address - Zip Code:96786-2013
Practice Address - Country:US
Practice Address - Phone:808-397-4638
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-08
Last Update Date:2022-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management