Provider Demographics
NPI:1902127715
Name:DAJ HEALTHCARE AND HOMECARE AGENCY LLC
Entity Type:Organization
Organization Name:DAJ HEALTHCARE AND HOMECARE AGENCY LLC
Other - Org Name:DENISSE DE JESUS JOSON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DENISSE
Authorized Official - Middle Name:DE JESUS
Authorized Official - Last Name:JOSON
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CNA
Authorized Official - Phone:808-343-5522
Mailing Address - Street 1:721 MCCULLY ST
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96826-3903
Mailing Address - Country:US
Mailing Address - Phone:808-343-5522
Mailing Address - Fax:
Practice Address - Street 1:721 MCCULLY ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96826-3903
Practice Address - Country:US
Practice Address - Phone:808-343-5522
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-15
Last Update Date:2010-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIW0547257601251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health