Organization
EREDULIN V JULIAN
Active
Other names
Julian's Adult Foster Family Home
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. EREDULIN V JULIAN (OWNER)
(808) 966-5450
Entity
Organization
Contact information
Practice address
17-202 IPUAIWAHA ST, KEAAU, HI 96749-8229
(808) 966-5450
(808) 966-5450
Mailing address
17-202 IPUAIWAHA ST., KEAAU, HI 96749
(808) 966-5450
(808) 966-5450
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
531819
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
376K00000X
TAXONOMY CODE
—
05
—
531819
—
HI
Enumeration date
11/30/2011
Last updated
11/30/2011
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