NPI 1356403976

Pancho and Jayvie's Adult Foster Care Home

Organisation Skilled Nursing Facility Keaau, HI

Practice location

Address: 16-123 Ainaloa Boulevard, Keaau, HI 96749
Phone: (808) 982-5004
Fax: (808) 982-5004
Mailing address: Rr 3 Box 1009, Pahoa, HI 96778-7500

Authorised official

Name: Jayvie Agcaoili Sumoba
Title: Owner
Phone: (808) 982-5004

Registered specialties

Skilled Nursing Facility Primary

Nursing & Custodial Care Facilities Taxonomy 314000000X Licence W02297664-01 (HI)

Other Skilled Nursing Facility providers in Hawaii →

Registry record

NPI: 1356403976
Entity type: Organization
NPI issued: 14 Dec 2006
Record last updated: 23 Jun 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.