Provider Demographics
NPI:1851084057
Name:HO'ALA I KE OLA, LLC
Entity Type:Organization
Organization Name:HO'ALA I KE OLA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:
Authorized Official - Last Name:WENTZEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-753-3965
Mailing Address - Street 1:PO BOX 1540
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96806-1540
Mailing Address - Country:US
Mailing Address - Phone:808-753-3935
Mailing Address - Fax:
Practice Address - Street 1:801 S BERETANIA ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-2501
Practice Address - Country:US
Practice Address - Phone:808-753-3935
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-01
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty