Organization Active NPI

Ku Aloha Ola Mau

  • Counselor
  • Honolulu, HI
National Provider Identifier
1376553107
Registry record updated Aug 1, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Legal business name
KU ALOHA OLA MAU
Practice address
1130 N Nimitz Hwy
C302
Honolulu, HI 96817
Phone
(808) 538-0704
Fax
(808) 538-0474
NPI assigned
Aug 8, 2006
Last updated
Aug 1, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2007

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

Authorized official

Name
Ms. Lisa Cook, LSW ACSW
Title
Executive Director
Phone
(808) 538-0704

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X NU Primary

Addresses

Primary practice location

1130 N Nimitz Hwy
C302
Honolulu, HI 96817

Mailing address

1130 N Nimitz Hwy
C302
Honolulu, HI 96817
Phone (808) 538-0704

Other identifiers 1

IdentifierTypeStateIssuer
509218-01MedicaidHI

Other names 1

  • Drug Addiction Services of Hawaii Inc Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI2 enrollments
Opioid treatment program
Medicare-enrolled since Jan 1, 2020

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20191213000714 HI Part B Supplier - Opioid Treatment Program (Otp) 2961673868 Practice locations: Hilo, HI; Honolulu, HI
O20200723002024 HI Part B Supplier - Clinic/Group Practice 2961673868 Receives reassigned benefits from 4 practitioners
Practice locations: Honolulu, HI

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
12D0901751Ku Aloha Ola Mau1130 N Nimitz Hwy Suite C302, Honolulu, HI 96817Certificate of waiverJun 4, 2027

National Provider Directory

National Provider Directory
Tax ID family
Drug Addiction Services of Hawaii Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

900 Leilani St
Hilo, HI 96720
Phone (808) 640-6609

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185926400000",
    "number": "1376553107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1130 N NIMITZ HWY",
            "address_2": "C302",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "96817",
            "telephone_number": "808-538-0704",
            "fax_number": "808-538-0474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 N NIMITZ HWY",
            "address_2": "C302",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "96817",
            "telephone_number": "808-538-0704",
            "fax_number": "808-538-0474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KU ALOHA OLA MAU",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-08",
        "last_updated": "2007-08-01",
        "status": "A",
        "authorized_official_last_name": "COOK",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "808-538-0704",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LSW ACSW"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "509218-01",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Drug Addiction Services of Hawaii Inc",
            "code": "4",
            "type": "Former Legal Business 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 Aug 1, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.