| NPI | 1548521164 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID D DERAUF Executive Director 808-791-9400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2012-05-30 |
| Last Update Date | 2014-11-25 |