Organization
KAUAI CARE CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARVIN BEDDOE (CEO)
(425) 392-4066
Entity
Organization
Contact information
Practice address
9611 WAENA ROAD, KAUAI, HI 96796
(808) 338-1681
(808) 338-1297
Mailing address
3326 160TH AVE SE, BELLEVUE, WA 98008-6418
(425) 392-4066
(425) 623-1517
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
—
—
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0-03831-1
—
HI
Enumeration date
06/15/2006
Last updated
03/08/2023
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