| NPI | 1245652783 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARMELITA DAGUIO CASIL Owner 808-671-0756 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: HI 3104A0625X) |
| Enumeration Date | 2014-01-17 |
| Last Update Date | 2014-01-17 |