- Enrollment id
- O20040526000564
- Enrollment state
- HI
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1184611022
- Multiple npi flag
- N
- Ccn
- 125004
- Associate id
- 0749261741
- Organization name
- GARDEN ISLE HEALTHCARE, LLC
- Doing business as name
- GARDEN ISLE HEALTHCARE AND REHABILITATION CENTER
- Incorporation date
- 2004-03-01
- Incorporation state
- HI
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- GARDEN ISLE HEALTHCARE AND REHABILITATION CENTER
- Affiliation entity name
- OHANA PACIFIC MANAGEMENT CO.
- Affiliation entity id
- 382
- Address line 1
- 3-3420 KUHIO HWY #300
- City
- LIHUE
- State
- HI
- Zip code
- 967661099