Provider Demographics
NPI:1619085859
Name:CHART REHABILITATION OF HAWAII INC
Entity Type:Organization
Organization Name:CHART REHABILITATION OF HAWAII INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT ADMINISTRATION
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:TAKAKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-523-9043
Mailing Address - Street 1:826 S KING ST
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-3009
Mailing Address - Country:US
Mailing Address - Phone:808-523-9043
Mailing Address - Fax:808-526-0673
Practice Address - Street 1:94-810 MOLOALO ST
Practice Address - Street 2:220
Practice Address - City:WAIPAHU
Practice Address - State:HI
Practice Address - Zip Code:96797-3355
Practice Address - Country:US
Practice Address - Phone:808-671-1711
Practice Address - Fax:808-671-1705
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-28
Last Update Date:2016-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIH102155Medicare PIN