| NPI | 1952994238 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID D. DERAUF Chief Executive Officer 808-791-9400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2021-02-17 |
| Last Update Date | 2021-02-17 |