Organization
WILSON IN HOME, INC.
Active
Other names
Wilson Homecare
Organization subpart
No
Provider details
NPI number
Authorized official
SHELLEY WILSON (PRESIDENT)
(808) 596-4486
Entity
Organization
Contact information
Practice address
711 KAPIOLANI BLVD STE 450, HONOLULU, HI 96813-5237
(808) 596-4486
(808) 356-1531
Mailing address
PO BOX 2058, HONOLULU, HI 96805-2058
(808) 596-4486
(808) 596-4822
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251J00000X
Nursing Care Agency
Primary
—
—
253Z00000X
In Home Supportive Care Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
505430-01
—
HI
01
—
533473-01
MEDICAID EPSDT
HI
Enumeration date
10/02/2006
Last updated
06/19/2024
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