Organization
EVERGREEN ADULT DAY CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL J PARK (OWNER)
(808) 946-7505
Entity
Organization
Contact information
Practice address
1500 KAPIOLANI BLVD STE 102E, HONOLULU, HI 96814-3732
(808) 372-8257
(808) 946-7571
Mailing address
1500 KAPIOLANI BLVD STE 102E, HONOLULU, HI 96814-3732
(808) 372-8257
(808) 946-7571
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000029
—
HI
Enumeration date
11/11/2020
Last updated
04/02/2025
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