Basic Information
| Provider Information | |||||||||
| NPI: | 1073235966 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | WEST HAWAII COMMUNITY HEALTH CENTER, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 75-5751 KUAKINI HWY STE 203 | ||||||||
| Address2: | |||||||||
| City: | KAILUA KONA | ||||||||
| State: | HI | ||||||||
| PostalCode: | 967401753 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8083263878 | ||||||||
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| Practice Location | |||||||||
| Address1: | 81-980 HALEKII ST STE 103 | ||||||||
| Address2: | |||||||||
| City: | KEALAKEKUA | ||||||||
| State: | HI | ||||||||
| PostalCode: | 967508177 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8083263878 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/16/2022 | ||||||||
| LastUpdateDate: | 09/16/2022 | ||||||||
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| AuthorizedOfficialLastName: | TAAFFE | ||||||||
| AuthorizedOfficialFirstName: | RICHARD | ||||||||
| AuthorizedOfficialMiddleName: | J | ||||||||
| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 8083263884 | ||||||||
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| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | WEST HAWAII COMMUNITY HEALTH CENTER, INC. | ||||||||
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| NPICertificationDate: | 09/12/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QF0400X | Y | Ambulatory Health Care Facilities | Clinic/Center | Federally Qualified Health Center (FQHC) |
No ID Information.