Organization
PETTY BASA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PETTY CAJALNE BASA (NA/PRIMARY CARE GIVER)
(808) 678-8331
Entity
Organization
Contact information
Practice address
94-249 PAIWA ST, WAIPAHU, HI 96797-3481
(808) 678-8331
(808) 678-8331
Mailing address
94-249 PAIWA ST, WAIPAHU, HI 96797-3481
(808) 678-8331
(808) 678-8331
Taxonomy
Speciality
Code
Description
License number
State
253J00000X
Foster Care Agency
Primary
—
HI
Other
Enumeration date
06/05/2014
Last updated
06/05/2014
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