NPIMap

Organization Active NPI

Providence Living LLC

  • Substance Abuse Rehabilitation Facility
  • Honolulu, HI
National Provider Identifier
1003413097
Registry record updated May 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
PROVIDENCE LIVING LLC
Practice address
1188 Bishop St Ste 1008
Honolulu, HI 96813-3304
Phone
(808) 445-6780
Fax
(888) 373-9844
NPI assigned
Oct 3, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 7, 2021

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

Authorized official

Name
Dr. William J Heran, PHD, LCSW
Title
Ceo
Phone
(808) 445-6780

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X Primary

Addresses

Primary practice location

1188 Bishop St Ste 1008
Honolulu, HI 96813-3304

Mailing address

1188 Bishop St Ste 1008
Honolulu, HI 96813-3304
Phone (808) 445-6780

Other names 1

  • Providence Treatment Other name

National Provider Directory

National Provider Directory
Tax ID family
Providence Living LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1188 Bishop St
Ste 1008
Honolulu, HI 96813
Phone (808) 445-6780

NPI Registry JSON

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

{
    "created_epoch": "1601683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620345600000",
    "number": "1003413097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1188 BISHOP ST STE 1008",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968133304",
            "telephone_number": "808-445-6780",
            "fax_number": "888-373-9844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1188 BISHOP ST STE 1008",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968133304",
            "telephone_number": "808-445-6780",
            "fax_number": "888-373-9844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE LIVING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-03",
        "last_updated": "2021-05-07",
        "certification_date": "2021-05-07",
        "status": "A",
        "authorized_official_last_name": "HERAN",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "808-445-6780",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD, LCSW"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Providence Treatment",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Providence Treatment",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Honolulu, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.