Provider Demographics
NPI:1184932345
Name:ISLANDS HOSPICE, INC.
Entity type:Organization
Organization Name:ISLANDS HOSPICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:LACKNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-412-4909
Mailing Address - Street 1:12680 HIGH BLUFF DR STE 150
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92130-2232
Mailing Address - Country:US
Mailing Address - Phone:918-576-3070
Mailing Address - Fax:918-516-0609
Practice Address - Street 1:820 MILILANI ST STE 400
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-2934
Practice Address - Country:US
Practice Address - Phone:808-550-2552
Practice Address - Fax:808-550-2551
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-21
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251G00000XAgenciesHospice Care, Community BasedGroup - Single Specialty
No207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative MedicineGroup - Single Specialty