Basic Information
| Provider Information | |||||||||
| NPI: | 1568739878 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | EASTER SEALS HAWAII | ||||||||
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| Mailing Information | |||||||||
| Address1: | 710 GREEN ST | ||||||||
| Address2: | |||||||||
| City: | HONOLULU | ||||||||
| State: | HI | ||||||||
| PostalCode: | 968132119 | ||||||||
| CountryCode: | US | ||||||||
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| Address1: | 710 GREEN ST | ||||||||
| Address2: | |||||||||
| City: | HONOLULU | ||||||||
| State: | HI | ||||||||
| PostalCode: | 968132119 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8085361015 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 11/30/2011 | ||||||||
| LastUpdateDate: | 11/30/2011 | ||||||||
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| AuthorizedOfficialLastName: | MATSUDA | ||||||||
| AuthorizedOfficialFirstName: | LEE ANN | ||||||||
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| AuthorizedOfficialTitleorPosition: | CFO | ||||||||
| AuthorizedOfficialTelephone: | 8085361015 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251V00000X | N | Agencies | Voluntary or Charitable | 252Y00000X | N | Agencies | Early Intervention Provider Agency | 251C00000X | Y | Agencies | Day Training, Developmentally Disabled Services |
No ID Information.