Provider Demographics
NPI:1710314646
Name:KILOHANA SENIOR ENRICHMENT CENTER
Entity Type:Organization
Organization Name:KILOHANA SENIOR ENRICHMENT CENTER
Other - Org Name:KILOHANA ADULT DAY CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:MORI
Authorized Official - Last Name:HAYAKAWA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-373-2882
Mailing Address - Street 1:5829 MAHIMAHI ST
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96821-2120
Mailing Address - Country:US
Mailing Address - Phone:808-373-3373
Mailing Address - Fax:808-373-3372
Practice Address - Street 1:5829 MAHIMAHI ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96821-2120
Practice Address - Country:US
Practice Address - Phone:808-373-2700
Practice Address - Fax:808-373-2733
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-10
Last Update Date:2013-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIADHC-8261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care