Provider Demographics
NPI:1053975698
Name:HI SECURE CARE CASE MANAGEMENT AGENCY LLC
Entity type:Organization
Organization Name:HI SECURE CARE CASE MANAGEMENT AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, CHIEF NURSE CASE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:LANCE
Authorized Official - Middle Name:TOSHIRO
Authorized Official - Last Name:AURIO
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:808-286-4835
Mailing Address - Street 1:94-076 AAAHI PL
Mailing Address - Street 2:
Mailing Address - City:MILILANI
Mailing Address - State:HI
Mailing Address - Zip Code:96789-1820
Mailing Address - Country:US
Mailing Address - Phone:808-286-4835
Mailing Address - Fax:844-825-7520
Practice Address - Street 1:94-076 AAAHI PL
Practice Address - Street 2:
Practice Address - City:MILILANI
Practice Address - State:HI
Practice Address - Zip Code:96789-1820
Practice Address - Country:US
Practice Address - Phone:808-286-4835
Practice Address - Fax:844-825-7520
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-29
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251B00000XAgenciesCase ManagementGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI000479Medicaid