Individual
CHANELLE LYNN PUALLILIA KEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2221 ANIANIKU ST, HONOLULU, HI 96813-1406
(808) 450-8897
Mailing address
PO BOX 22714, HONOLULU, HI 96823-2714
(808) 450-8897
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
47-3166133
HI
251E00000X
Home Health Agency
Primary
47-3166133
HI
251J00000X
Nursing Care Agency
47-3166133
HI
251S00000X
Community/Behavioral Health Agency
47-3166133
HI
253J00000X
Foster Care Agency
47-3166133
HI
253Z00000X
In Home Supportive Care Agency
47-3166133
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
47-3166133
—
HI
Enumeration date
03/27/2015
Last updated
03/27/2015
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