| NPI | 1023373974 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMSIL CANNON Administrator 808-533-3157 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: HI OHCA#105-C) |
| Enumeration Date | 2012-07-06 |
| Last Update Date | 2012-07-06 |