Provider Demographics
NPI:1326340514
Name:HAUMEA HOME HEALTH AGENCY LLC
Entity Type:Organization
Organization Name:HAUMEA HOME HEALTH AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PATIENT SERVICES
Authorized Official - Prefix:MS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:808-631-1548
Mailing Address - Street 1:5969 PILIKUA PL
Mailing Address - Street 2:
Mailing Address - City:KAPAA
Mailing Address - State:HI
Mailing Address - Zip Code:96746-9702
Mailing Address - Country:US
Mailing Address - Phone:808-631-1548
Mailing Address - Fax:808-823-6840
Practice Address - Street 1:5969 PILIKUA PL
Practice Address - Street 2:
Practice Address - City:KAPAA
Practice Address - State:HI
Practice Address - Zip Code:96746-9702
Practice Address - Country:US
Practice Address - Phone:808-631-1548
Practice Address - Fax:808-823-6840
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-22
Last Update Date:2010-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIHHA-48251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIHHA-48OtherSTATE OF HAWAII DEPARTMENT OF HEALTH