NPIMap

Organization Active NPI

Hale Makua Health Services

  • Skilled Nursing Facility
  • Wailuku, HI
National Provider Identifier
1912907759
Registry record updated Mar 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
73-N Issued in HI
Legal business name
HALE MAKUA HEALTH SERVICES
Practice address
1540 Lower Main St
Wailuku, HI 96793-1958
Phone
(808) 243-1722
Fax
(808) 243-1744
NPI assigned
Jul 22, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2017

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

Authorized official

Name
Wesley Lo
Title
Chief Executive Officer
Phone
(808) 877-2761

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 73-N HI Primary

Addresses

Primary practice location

1540 Lower Main St
Wailuku, HI 96793-1958

Mailing address

472 Kaulana St
Kahului, HI 96732-2050
Phone (808) 877-2761

Other identifiers 1

IdentifierTypeStateIssuer
081553-01MedicaidHI

Other names 1

  • HALE MAKUA - WAILUKU Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061017000572 HI Part A Provider - Skilled Nursing Facility 3779536537 Practice locations: Wailuku, HI

Skilled nursing facility certification: CCN 125056

Legal name
HALE MAKUA HEALTH SERVICES
Doing business as
HALE MAKUA WAILUKU
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Nov 22, 2006
Last certification
Nov 15, 2024
Beds
90
Ownership / control type
Nonprofit Corporation
Organization structure
CorporationNon-profit
Incorporated
Jan 15, 1954 in HI
Enrollment address
1540 Lower Main St
Wailuku, HI 96793-1958
Nursing home name
HALE MAKUA - WAILUKU

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Nursing home

Medicare Care Compare
Listed as
Hale Makua - WailukuCCN 125056
Overall star rating
5 of 5
Health inspections
5 of 5
Staffing
5 of 5
Quality measures
5 of 5
Type
Medicare and Medicaid
Ownership
Non profit - Corporation
Certified
Nov 22, 2006
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
9074.0 residents per day on average

Processed by Care Compare on Aug 1, 2026.

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 17

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

NameRoleSinceShare
Josiah Nishita Individual Corporate DirectorDirector - Non-Voting Apr 1, 2020
Grant Chun Individual Corporate DirectorDirector Jan 1, 2017
Eileen Wachi Individual Corporate DirectorDirector Jun 1, 2017
Roy Sakamoto Individual Corporate DirectorDirector Mar 1, 2015
Tracy a Dorheim Individual Corporate DirectorDirector Apr 17, 2025
Ohana Pacific Management Company Inc Organization, Kaneohe, HI Corporation, For-profit Operational/Managerial Control Jan 1, 2020
Adp of the SNF Dec 2, 2025
County of Maui-Department of Finance Organization, Wailuku, HI Non-profit Adp of the SNF Nov 1, 2018
Richard S Kishaba Individual Corporate DirectorDirector Jan 1, 2020
Wesley Lo Individual Corporate OfficerChief Executive Officer Dec 1, 2016
Corporate DirectorDirector Jan 1, 2019
Operational/Managerial Control Dec 1, 2016
Adp of the SNF Dec 1, 2016
Alexander McBarnet Individual Corporate DirectorSecretary/Director Mar 1, 2015
Edward Romson Individual Corporate DirectorChairman of the Board Jan 1, 2017
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 Adp of the SNF Aug 1, 2024
Paul Mattfeld Individual Operational/Managerial Control Aug 11, 2025
Adp of the SNF Aug 11, 2025
Suanne Morikuni Individual Operational/Managerial ControlCfo Jan 1, 2020
Adp of the SNF Jan 1, 2020
Michael Munekiyo Individual Corporate DirectorDirector Mar 1, 2015

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 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 3

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": "1121990400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490227200000",
    "number": "1912907759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "472 KAULANA ST",
            "city": "KAHULUI",
            "state": "HI",
            "postal_code": "967322050",
            "telephone_number": "808-877-2761",
            "fax_number": "808-871-9262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1540 LOWER MAIN ST",
            "city": "WAILUKU",
            "state": "HI",
            "postal_code": "967931958",
            "telephone_number": "808-243-1722",
            "fax_number": "808-243-1744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HALE MAKUA HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-22",
        "last_updated": "2017-03-23",
        "status": "A",
        "authorized_official_last_name": "LO",
        "authorized_official_first_name": "WESLEY",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "808-877-2761"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "HI",
            "license": "73-N",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "081553-01",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HALE MAKUA - WAILUKU",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Wailuku, HI

Sources for this page

Verify at the official NPI Registry.