Provider Demographics
NPI:1831427608
Name:ALOHA HABILITATION SERVICES, INC.
Entity type:Organization
Organization Name:ALOHA HABILITATION SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/SECRETARY
Authorized Official - Prefix:MR
Authorized Official - First Name:JAY
Authorized Official - Middle Name:
Authorized Official - Last Name:RAYMUNDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-497-8157
Mailing Address - Street 1:100 KAHELU AVENUE
Mailing Address - Street 2:SUITE 231
Mailing Address - City:MILILANI
Mailing Address - State:HI
Mailing Address - Zip Code:96789-3962
Mailing Address - Country:US
Mailing Address - Phone:808-622-4200
Mailing Address - Fax:808-622-4211
Practice Address - Street 1:100 KAHELU AVENUE
Practice Address - Street 2:SUITE 231
Practice Address - City:MILILANI
Practice Address - State:HI
Practice Address - Zip Code:96789-3962
Practice Address - Country:US
Practice Address - Phone:808-622-4200
Practice Address - Fax:808-622-4211
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-06
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI251E00000X
251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI509226Medicaid