Provider Demographics
NPI:1639782238
Name:HAWAII HOME CARE INC
Entity Type:Organization
Organization Name:HAWAII HOME CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LORELEI
Authorized Official - Middle Name:
Authorized Official - Last Name:CROWDER
Authorized Official - Suffix:
Authorized Official - Credentials:RN BSN
Authorized Official - Phone:808-927-5092
Mailing Address - Street 1:700 BISHOP ST STE 610
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-4124
Mailing Address - Country:US
Mailing Address - Phone:808-927-5092
Mailing Address - Fax:
Practice Address - Street 1:700 BISHOP ST STE 610
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-4124
Practice Address - Country:US
Practice Address - Phone:808-927-5092
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-25
Last Update Date:2020-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIHCA-81Medicaid