1457410532 NPI number — KAPOLEI COUNSELING LTD

Table of content: (NPI 1457410532)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457410532 NPI number — KAPOLEI COUNSELING LTD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
KAPOLEI COUNSELING LTD
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:
1457410532
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/20/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
91-110 HANUA ST
Provider Second Line Business Mailing Address:
#208A
Provider Business Mailing Address City Name:
KAPOLEI
Provider Business Mailing Address State Name:
HI
Provider Business Mailing Address Postal Code:
96707-1742
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
808-682-5808
Provider Business Mailing Address Fax Number:
808-682-5808

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
91-110 HANUA ST
Provider Second Line Business Practice Location Address:
#208A
Provider Business Practice Location Address City Name:
KAPOLEI
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96707-1742
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-682-5808
Provider Business Practice Location Address Fax Number:
808-682-5808
Provider Enumeration Date:
12/06/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MANGIALETTI
Authorized Official First Name:
NADA
Authorized Official Middle Name:
ROSE
Authorized Official Title or Position:
OWNER, PRESIDENT
Authorized Official Telephone Number:
808-682-5808

Provider Taxonomy Codes

  • Taxonomy code: 103TC0700X , with the licence number:  307 , registered in the state of HI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 508654 . This is a "HMA" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".
  • Identifier: 420425 . This is a "VALUE OPTIONS" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".
  • Identifier: 1413644 . This is a "UHA" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".
  • Identifier: 01758802 , issued by the state of ( HI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 01758802 . This is a "ALOHACAREQUEST" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".




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