1114355328 NPI number — TRISCELE SERVICES, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1114355328 NPI number — TRISCELE SERVICES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TRISCELE SERVICES, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1114355328
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/11/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
95-1063 KAAPEHA ST
Provider Second Line Business Mailing Address:
#136
Provider Business Mailing Address City Name:
MILILANI
Provider Business Mailing Address State Name:
HI
Provider Business Mailing Address Postal Code:
96789-4884
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
808-551-5632
Provider Business Mailing Address Fax Number:
808-621-0540

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
98-211 PALI MOMI ST STE 600
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
AIEA
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96701-4337
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-551-5632
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/24/2013

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
JONES
Authorized Official First Name:
DARLENE
Authorized Official Middle Name:
M
Authorized Official Title or Position:
LICENSED MENTAL HEALTH COUNSELOR
Authorized Official Telephone Number:
808-551-5632

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X , with the licence number:  174 , registered in the state of HI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YM0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)