Provider Demographics
NPI:1619343142
Name:STATE OF HAWAII EXECUTIVE OFFICE ON AGING
Entity Type:Organization
Organization Name:STATE OF HAWAII EXECUTIVE OFFICE ON AGING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:TERRI
Authorized Official - Middle Name:
Authorized Official - Last Name:BYERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-586-0100
Mailing Address - Street 1:250 S HOTEL STREET
Mailing Address - Street 2:406
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-2831
Mailing Address - Country:US
Mailing Address - Phone:808-586-0100
Mailing Address - Fax:808-586-0185
Practice Address - Street 1:250 S HOTEL ST
Practice Address - Street 2:406
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-2831
Practice Address - Country:US
Practice Address - Phone:808-586-0100
Practice Address - Fax:808-586-0185
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-19
Last Update Date:2015-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Single Specialty