Individual
MAWICELICA M. BALISACAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
94-941 KUHAULUA ST, WAIPAHU, HI 96797-2844
(808) 304-3590
(808) 379-0468
Mailing address
94-941 KUHAULUA ST, WAIPAHU, HI 96797-2844
(808) 304-3590
(808) 379-0468
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
1-210057
HI
Other
Enumeration date
08/22/2021
Last updated
08/22/2021
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