NPIMap

Organization Active NPI

Garden Isle Healthcare, LLC

  • Skilled Nursing Facility
  • Lihue, HI
National Provider Identifier
1184611022
Registry record updated Oct 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
68-N Issued in HI
Legal business name
GARDEN ISLE HEALTHCARE, LLC
Practice address
3420 Kuhio Highway
# 300
Lihue, HI 96766
Phone
(808) 247-1802
Fax
(808) 247-6515
NPI assigned
Oct 5, 2005
Last updated
Oct 3, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Randall Hata
Title
Cfo
Phone
(808) 247-0003

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 68-N HI Primary

Addresses

Primary practice location

3420 Kuhio Highway
# 300
Lihue, HI 96766

Mailing address

45-181 Waikalua Rd
Kaneohe, HI 96744-2765
Phone (808) 247-0003

Other identifiers 2

IdentifierTypeStateIssuer
0000246736OtherHIHMSA
551178-01MedicaidHI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040526000564 HI Part A Provider - Skilled Nursing Facility 0749261741 Practice locations: Lihue, HI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1184611022. Details of each certification follow.

Skilled nursing facility certification: CCN 125004

Legal name
GARDEN ISLE HEALTHCARE, LLC
Doing business as
GARDEN ISLE HEALTHCARE AND REHABILITATION CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Jan 1, 1967
Last certification
Feb 23, 2024
Beds
110
Ownership / control type
Corporation
Multi-facility organization
Ohana Pacific Management Company Inc.,
Most recent change of ownership
Jun 1, 2004
Organization structure
LLCProprietary
Incorporated
Mar 1, 2004 in HI
Enrollment address
3-3420 Kuhio Hwy #300
Lihue, HI 96766-1099
Nursing home name
GARDEN ISLE HEALTHCARE AND REHABILITATION CENTER
Affiliated entity
OHANA PACIFIC MANAGEMENT CO.

Care Compare: Nursing home

Medicare Care Compare
Listed as
Garden Isle Healthcare and Rehabilitation CenterCCN 125004 · All quality measures
Overall star rating
5 of 5
Health inspections
4 of 5
Staffing
5 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Jan 1, 1967
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
11073.3 residents per day on average
Chain
Ohana Pacific Management Co.6 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
12D1027953Garden Isle Healthcare, LLC3-3420 Kuhio Highway, Suite 300, Lihue, HI 96766Certificate of waiverJul 15, 2028

National Provider Directory

National Provider Directory

Locations

3-3420 Kuhio Hwy
Ste 300
Lihue, HI 96766
Phone (808) 245-1802

Interoperability endpoints

  • Direct secure messaging: lihue.garden.isle.rehabilitation.and.healthcare@hawaiihie.medicity.net

Ownership & related parties

All disclosed owners & managing parties 11

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Bronson Ho Individual Operational/Managerial Control Jun 1, 2020
Adp of the SNF Jun 1, 2020
Richard S. Kishaba 2010 Dynasty Trust Organization, Kaneohe, HI 5% Or Greater Indirect Ownership Interest Jul 30, 2010 90%
Wilcox Memorial Hospital Organization, Lihue, HI Corporation, Medical provider/supplier, Non-profit Adp of the SNF Dec 1, 2019
Ohana Pacific Management Company Inc Organization, Kaneohe, HI Corporation, Holding company, For-profit, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Dec 23, 2003 100%
Operational/Managerial Control Dec 23, 2003
Adp of the SNF Dec 10, 2025
Randall I Hata Individual Operational/Managerial Control Dec 23, 2003
Adp of the SNF Dec 23, 2003
Richard S Kishaba Individual 5% Or Greater Indirect Ownership Interest Dec 23, 2003 10%
Operational/Managerial Control Dec 23, 2003
Adp of the SNF Dec 23, 2003
Indirect Ownership Interest Dec 23, 2003 10%
Wesley Lo Individual Operational/Managerial Control Jan 1, 2020
Adp of the SNF Jan 1, 2020
Andrew Lore Individual Operational/Managerial Control Feb 1, 2022
Adp of the SNF Feb 1, 2022
Pamela McClennon Individual Operational/Managerial Control Apr 1, 2025
Adp of the SNF Apr 1, 2025
Arnold WH Kop Individual Operational/Managerial Control Jan 1, 2025
Adp of the SNF Jan 1, 2025
Suanne Morikuni Individual Operational/Managerial Control Jan 1, 2019
Adp of the SNF Jan 1, 2019

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 10

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 4

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1128470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664755200000",
    "number": "1184611022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45-181 WAIKALUA RD",
            "city": "KANEOHE",
            "state": "HI",
            "postal_code": "967442765",
            "telephone_number": "808-247-0003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3420 KUHIO HIGHWAY",
            "address_2": "# 300",
            "city": "LIHUE",
            "state": "HI",
            "postal_code": "96766",
            "telephone_number": "808-247-1802",
            "fax_number": "808-247-6515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARDEN ISLE HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-05",
        "last_updated": "2022-10-03",
        "certification_date": "2022-10-03",
        "status": "A",
        "authorized_official_last_name": "HATA",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "808-247-0003"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "HI",
            "license": "68-N",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMSA",
            "identifier": "0000246736",
            "state": "HI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "551178-01",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lihue, HI

Sources for this page

Verify at the official NPI Registry.