NPIMap

Organization Active NPI

Leeward Early Childhood Services Program

  • Early Intervention Provider Agency
  • Pearl City, HI
National Provider Identifier
1821367723
Registry record updated Dec 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Early Intervention Provider AgencyTaxonomy code 252Y00000X
Legal business name
LEEWARD EARLY CHILDHOOD SERVICES PROGRAM
Practice address
860 Fourth St
Room #150
Pearl City, HI 96782-3312
Phone
(808) 453-6960
Fax
(808) 453-6964
NPI assigned
Dec 21, 2011
Last updated
Dec 21, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2011

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

Authorized official

Name
Ms. Mae M. Braceros
Title
Program Manager
Phone
(808) 453-6960

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Early Intervention Provider Agency 252Y00000X NU Primary

Addresses

Primary practice location

860 Fourth St
Room #150
Pearl City, HI 96782-3312

Mailing address

860 Fourth St
Room #150
Pearl City, HI 96782-3312
Phone (808) 453-6960

Other identifiers 1

IdentifierTypeStateIssuer
64626802MedicaidHI

National Provider Directory

National Provider Directory
Tax ID family
Central Oahu Comm Menta103 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

860 4th St
Ste 150
Pearl City, HI 96782
Phone (808) 453-6960

Practitioners & affiliated clinicians

Practitioners 6

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": "1324425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1324425600000",
    "number": "1821367723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "860 FOURTH ST",
            "address_2": "ROOM #150",
            "city": "PEARL CITY",
            "state": "HI",
            "postal_code": "967823312",
            "telephone_number": "808-453-6960",
            "fax_number": "808-453-6964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "860 FOURTH ST",
            "address_2": "ROOM #150",
            "city": "PEARL CITY",
            "state": "HI",
            "postal_code": "967823312",
            "telephone_number": "808-453-6960",
            "fax_number": "808-453-6964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEEWARD EARLY CHILDHOOD SERVICES PROGRAM",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-21",
        "last_updated": "2011-12-21",
        "status": "A",
        "authorized_official_last_name": "BRACEROS",
        "authorized_official_first_name": "MAE",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "PROGRAM MANAGER",
        "authorized_official_telephone_number": "808-453-6960",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64626802",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pearl City, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2011; 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.