Provider Demographics
NPI:1417352063
Name:HI'ILANI HEALTH CORPORATION
Entity Type:Organization
Organization Name:HI'ILANI HEALTH CORPORATION
Other - Org Name:LIFE CONNECTIONS, INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CORPORATE OFFICER/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAY
Authorized Official - Middle Name:
Authorized Official - Last Name:RAYMUNDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-497-8157
Mailing Address - Street 1:108 OLOKANI PL
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:WAHIAWA
Mailing Address - State:HI
Mailing Address - Zip Code:96786-4812
Mailing Address - Country:US
Mailing Address - Phone:808-497-8157
Mailing Address - Fax:
Practice Address - Street 1:108 OLOKANI PLACE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:WAHIAWA
Practice Address - State:HI
Practice Address - Zip Code:96786
Practice Address - Country:US
Practice Address - Phone:808-497-8157
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-24
Last Update Date:2015-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health