Individual
JUDY HERMOSURA CANLAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
94-534 HAKEA PL, WAIPAHU, HI 96797-4761
(808) 779-6187
(808) 200-5938
Mailing address
94-534 HAKEA PL, WAIPAHU, HI 96797-4761
(808) 779-6187
(808) 200-5938
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
1-200077
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000848
—
HI
Enumeration date
06/06/2022
Last updated
06/07/2022
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