EVERGREEN ADC HAWAII – NPI #1063982627
Clinic/Center

EVERGREEN ADC HAWAII is an AHC clinic located in HONOLULU, HI. NPPES has assigned the NPI number 1063982627 to EVERGREEN ADC HAWAII on November 27, 2018. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 261QA0600X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Adult Day Care

The NPI profile was last updated on Jun 04, 2025. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for EVERGREEN ADC HAWAII below.

NPI Profile for
EVERGREEN ADC HAWAII

NPI Number
1063982627
Enumeration Date

(more than 7 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
EVERGREEN ADC HAWAII
Primary location
1124 FORT STREET MALL FL 2
HONOLULU, HI 96813-2715
Phone: (808) 372-8257 Fax: (808) 946-7571
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
DANIEL PARK
OWNER
Phone: (808) 372-8257
Updated
Certification Date
Jun 04, 2025

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QA0600X
- Clinic/Center / Adult Day Care (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.