Bobby Benson Center

Primary specialty

Children's Substance Abuse Rehabilitation FacilityTaxonomy code 3245S0500X

License

53-STF Issued in HI

Legal business name

BOBBY BENSON CENTER

Practice address

56-660 Kamehameha Hwy
Kahuku, HI 96731-2210

Phone

(808) 293-7555

Fax

(808) 293-7196

NPI assigned

Dec 4, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Jeffrie Wagner

Title

Executive Director

Phone

(808) 293-7555

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1306904461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "56-660 KAMEHAMEHA HWY",
            "city": "KAHUKU",
            "state": "HI",
            "postal_code": "967312210",
            "telephone_number": "808-293-7555",
            "fax_number": "808-293-7196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "56-660 KAMEHAMEHA HWY",
            "city": "KAHUKU",
            "state": "HI",
            "postal_code": "967312210",
            "telephone_number": "808-293-7555",
            "fax_number": "808-293-7196"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOBBY BENSON CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WAGNER",
        "authorized_official_first_name": "JEFFRIE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "808-293-7555",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3245S0500X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children",
            "state": "HI",
            "license": "53-STF",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Harry Joseph Ashe, M.D.
• James Lawrence Askew, CPNP
• Naitia Auelua, CLINICAL SOCIAL WORK
• Claudia Balli
• Jeffrey James Baumann, MA
• Bobby Benson Center
• Constance Bridgman, NP-C
• Caitlin Bruce, FNP-BC
• Nakita Kyong Brusnighan, DDS
• Lawrence Woodson Buchner, PHARM.D.

• Children's Substance Abuse Rehabilitation Facility in Kahuku, HI
• Providers in Kahuku, HI by specialty
• Children's Substance Abuse Rehabilitation Facility in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.