NPIMap

Organization Active NPI

Family Support Services of West Hawaii

  • Rehabilitation Clinic/Center
  • Kailua Kona, HI
National Provider Identifier
1649687120
Registry record updated Jul 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Clinic/CenterTaxonomy code 261QR0400X
Legal business name
FAMILY SUPPORT SERVICES OF WEST HAWAII
Practice address
75-127 Lunapule Rd Ste 11
Kailua Kona, HI 96740-2119
Phone
(808) 334-4115
Fax
(808) 326-4063
NPI assigned
Jul 17, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2014

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

Authorized official

Name
Ray Wofford
Title
Executive Director
Phone
(808) 334-4115

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Clinic/Center 261QR0400X Primary

Addresses

Primary practice location

75-127 Lunapule Rd Ste 11
Kailua Kona, HI 96740-2119

Mailing address

75-127 Lunapule Rd Ste 11
Kailua Kona, HI 96740-2119
Phone (808) 334-4115

Other identifiers 1

IdentifierTypeStateIssuer
64642402MedicaidHI

National Provider Directory

National Provider Directory
Tax ID family
Family Support Services of West Hawaii2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

75-127 Lunapule Rd
Ste 11
Kailua Kona, HI 96740
Phone (808) 326-7778

NPI Registry JSON

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

{
    "created_epoch": "1405555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405555200000",
    "number": "1649687120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75-127 LUNAPULE RD STE 11",
            "city": "KAILUA KONA",
            "state": "HI",
            "postal_code": "967402119",
            "telephone_number": "808-334-4115",
            "fax_number": "808-326-4063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75-127 LUNAPULE RD STE 11",
            "city": "KAILUA KONA",
            "state": "HI",
            "postal_code": "967402119",
            "telephone_number": "808-334-4115",
            "fax_number": "808-326-4063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY SUPPORT SERVICES OF WEST HAWAII",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-17",
        "last_updated": "2014-07-17",
        "status": "A",
        "authorized_official_last_name": "WOFFORD",
        "authorized_official_first_name": "RAY",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "808-334-4115"
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64642402",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kailua Kona, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2014; 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.