Provider Demographics
NPI:1710129945
Name:LANAKILA PACIFIC
Entity Type:Organization
Organization Name:LANAKILA PACIFIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:REMY
Authorized Official - Middle Name:S
Authorized Official - Last Name:RUEDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-356-8558
Mailing Address - Street 1:1809 BACHELOT ST
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817-2430
Mailing Address - Country:US
Mailing Address - Phone:808-531-0555
Mailing Address - Fax:808-524-8657
Practice Address - Street 1:1809 BACHELOT ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-2430
Practice Address - Country:US
Practice Address - Phone:808-531-0555
Practice Address - Fax:808-524-8657
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-02
Last Update Date:2009-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332U00000XSuppliersHome Delivered Meals
No251E00000XAgenciesHome Health