State of Hawaii Department of Health
Organization Active NPI Community/Behavioral Health Agency · Honokaa, HI
NPI 1306029947 · NPPES record last updated Jun 17, 2014
Key facts
- NPI
- 1306029947
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Behavioral Health Agency 251S00000X
- Legal business name
- STATE OF HAWAII DEPARTMENT OF HEALTH
- Practice address
- 45-3380 Mamane St
#4
Honokaa, HI 96727-6933 - Phone
- (808) 933-0409
- NPI assigned
- Dec 5, 2007
- Organization subpart
- Yes
- Parent organization (as reported)
- STATE OF HAWAII DEPARTMENT OF HEALTH
Authorized official
- Name
- Raquel B. Nakahara
- Title
- Financial Resource Specialist
- Phone
- (808) 590-7320
Other NPIs on the same Medicare enrollment 23
Corporate family (same tax ID) 24
Practitioners 3
-
Tammy Lee Wheeler, APRN-RX
-
Nidhi Anna Chabora, APRN-RX
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in HI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040127000902 | HI | Part B Supplier - Clinic/Group Practice | 5395648539 |
Receives reassigned benefits from 23 practitioners 23 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Kealakekua, HI; Lahaina, HI; Lanai City, HI; Kaneohe, HI; Lihue, HI; Naalehu, HI; Pahoa, HI; Pearl City, HI… |
National Provider Directory
- Tax ID family
- Hawaii County Comm HLTH
- Part of
- Hawaii County Comm HLTH
Locations
45-3380 Mamane St
Unit 4
Honokaa, HI 96727
Phone (808) 640-1141
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | Yes |
Addresses
Primary practice location
45-3380 Mamane St
#4
Honokaa, HI 96727-6933
Mailing address
1250 Punchbowl St
RM 256
Honolulu, HI 96813-2416
Phone (808) 590-7320
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 53937219 | Medicaid | HI |
Other names
- East Hawaii Community Mental Health Center-Honokaa Clinic
Other providers in Honokaa, HI
- Gretchen J Salmon
- Wendi Kanani Sanchez
- Allyson Kahealani Schuckert
- Scott T. Nakahara, D.D.S.
- Ocatilla Seiber
- Ultrasound Specialties, LLC
- Nani Waddoups
- Raymond B. Wertheim
- Adam Wieland
- Jamuna Wyss
All providers in Honokaa, HI · Community/Behavioral Health Agency in Hawaii
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 17, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.