MBSB Hualalai, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

MBSB HUALALAI, LLC

Practice address

75-181 Hualalai Rd
Kailua Kona, HI 96740-1787

Phone

(808) 329-7878

NPI assigned

Nov 2, 2007

Organization subpart

No

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

Authorized official

Name

Marvin Bart Beddoe

Title

Managing Member

Phone

(425) 392-4066

Specialties & licenses 1

Addresses

Other names 2

• REGENCY AT HUALALAI Doing business as
• Regency Hualalai Doing business as

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

CLIA laboratory certificates

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

{
    "created_epoch": "1193961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1013196344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3326 160TH AVE SE STE 120",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980086418",
            "telephone_number": "425-392-4066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75-181 HUALALAI RD",
            "city": "KAILUA KONA",
            "state": "HI",
            "postal_code": "967401787",
            "telephone_number": "808-329-7878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MBSB HUALALAI, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-02",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "BEDDOE",
        "authorized_official_first_name": "MARVIN",
        "authorized_official_middle_name": "BART",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "425-392-4066"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "REGENCY AT HUALALAI",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Regency Hualalai",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Luther T. Matsen
• Laurie Matzdorf
• Gage Matzen
• Corinne Maul de Soto, ND
• Maunakea Medical Services Inc
• David McCandless, M.D.
• Lillian McCollum, MS, APRN-RX, NP-C
• McCool Counseling Services, L.L.C.
• Dawn M. B. McCool, CRNA
• Natasha McCool, LMFT

• All providers in Kailua Kona, HI
• Assisted Living Facility in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.