Provider Demographics
NPI:1598765414
Name:LEKI, INCORPORATED
Entity Type:Organization
Organization Name:LEKI, INCORPORATED
Other - Org Name:CRAWFORD'S CONVALESCENT HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALICE
Authorized Official - Middle Name:KIM
Authorized Official - Last Name:LEW
Authorized Official - Suffix:
Authorized Official - Credentials:NHA-8
Authorized Official - Phone:808-949-7593
Mailing Address - Street 1:PO BOX 75688
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96836-0688
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:469 ENA RD
Practice Address - Street 2:2301
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96815-1749
Practice Address - Country:US
Practice Address - Phone:808-949-7593
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-21
Last Update Date:2013-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI6-ICF313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI00845801Medicaid