Organization
GARDEN ISLE HEALTHCARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RANDALL HATA (CFO)
(808) 247-0003
Entity
Organization
Contact information
Practice address
3420 KUHIO HIGHWAY, # 300, LIHUE, HI 96766
(808) 247-1802
(808) 247-6515
Mailing address
45-181 WAIKALUA RD, KANEOHE, HI 96744-2765
(808) 247-0003
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
68-N
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000246736
HMSA
HI
05
—
551178-01
—
HI
Enumeration date
10/05/2005
Last updated
10/03/2022
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