| NPI | 1285396622 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLENN MICHAEL MCCLEARY Executive Director 808-321-1807 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 261QD1600X Clinic/Center, Developmental Disabilities |
| Enumeration Date | 2021-10-13 |
| Last Update Date | 2021-10-13 |