Provider Demographics
NPI:1922010859
Name:ST. FRANCIS COMMUNITY HEALTH SERVICES
Entity Type:Organization
Organization Name:ST. FRANCIS COMMUNITY HEALTH SERVICES
Other - Org Name:ST. FRANCIS HOME CARE SERVICES - KAUAI
Other - Org Type:Other Name
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:SISTER AGNELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:CHING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-547-8002
Mailing Address - Street 1:PO BOX 29700
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96820-2100
Mailing Address - Country:US
Mailing Address - Phone:808-547-8050
Mailing Address - Fax:808-547-8058
Practice Address - Street 1:4473 PAHEE ST
Practice Address - Street 2:SUITE N
Practice Address - City:LIHUE
Practice Address - State:HI
Practice Address - Zip Code:96766-2037
Practice Address - Country:US
Practice Address - Phone:808-245-6430
Practice Address - Fax:808-246-8620
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIHHA-7251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI1072Medicaid
HI085766-01Medicaid
HIM21030-4Medicare ID - Type UnspecifiedHMSA 65 C+ (MEDICARE HMO)
HI085766-01Medicaid