# JACO REHAB MILILANI LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1508314089
- **Authorized official:** JACO J. VAN DELDEN P.T. (OWNER)
- **Authorized official phone:** (808) 381-8947

## Contact information

- **Practice address:** 95-1105 AINAMAKUA DRIVE, SUITE 203, MILILANI, HI 96789
- **Practice address phone:** (808) 381-8947
- **Practice address fax:** (808) 591-2245
- **Mailing address:** 1401 S BERETANIA ST, SUITE 550, HONOLULU, HI 96814-1870
- **Mailing address phone:** (808) 381-8947
- **Mailing address fax:** (808) 591-2245

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 225100000X | Physical Therapist | PT-1582 | HI | Yes |

## Other

- **Enumeration date:** 09/14/2016
- **Last updated:** 09/14/2016