Provider Demographics
NPI:1952447146
Name:HAWAII ISLAND ADULT CARE, INC.
Entity Type:Organization
Organization Name:HAWAII ISLAND ADULT CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARCIA
Authorized Official - Middle Name:A K
Authorized Official - Last Name:SAQUING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-961-3747
Mailing Address - Street 1:561 KUPUNA PL
Mailing Address - Street 2:
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-3935
Mailing Address - Country:US
Mailing Address - Phone:808-961-3747
Mailing Address - Fax:808-961-3740
Practice Address - Street 1:34 RAINBOW DR
Practice Address - Street 2:
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-2056
Practice Address - Country:US
Practice Address - Phone:808-961-3747
Practice Address - Fax:808-961-3740
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-29
Last Update Date:2020-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI505399251V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI505399OtherPROVIDER NUMBER