Organization
EVERGREEN ADC HAWAII
Active
Organization
EVERGREEN ADC HAWAII
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL PARK (OWNER)
(808) 372-8257
Entity
Organization
Contact information
Practice address
1124 FORT STREET MALL FL 2, HONOLULU, HI 96813-2715
(808) 372-8257
(808) 946-7571
Mailing address
1124 FORT STREET MALL FL 2, HONOLULU, HI 96813-2715
(808) 372-8257
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
—
—
Other
Enumeration date
11/27/2018
Last updated
06/04/2025
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