Provider Demographics
NPI:1750509857
Name:WAIANAE DISTRICT COMPREHENSIVE HEALTH AND HOSPITAL BOARD, INCORPORATED
Entity Type:Organization
Organization Name:WAIANAE DISTRICT COMPREHENSIVE HEALTH AND HOSPITAL BOARD, INCORPORATED
Other - Org Name:WCCHC ENABLING SERVICES AND CASE MANAGEMENT
Other - Org Type:Other Name
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:Z
Authorized Official - Last Name:CHEN
Authorized Official - Suffix:
Authorized Official - Credentials:MBA, CMPE
Authorized Official - Phone:80808-697-3300
Mailing Address - Street 1:86-260 FARRINGTON HWY
Mailing Address - Street 2:
Mailing Address - City:WAIANAE
Mailing Address - State:HI
Mailing Address - Zip Code:96792-3128
Mailing Address - Country:US
Mailing Address - Phone:808-697-3300
Mailing Address - Fax:808-697-3687
Practice Address - Street 1:86-260 FARRINGTON HWY
Practice Address - Street 2:
Practice Address - City:WAIANAE
Practice Address - State:HI
Practice Address - Zip Code:96792-3128
Practice Address - Country:US
Practice Address - Phone:808-697-3300
Practice Address - Fax:808-697-3687
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WAIANAE DISTRICT COMPREHENSIVE HEALTH AND HOSPITAL BOARD, INCORPORATED
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-04-23
Last Update Date:2009-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty
No172V00000XOther Service ProvidersCommunity Health WorkerGroup - Multi-Specialty