| NPI | 1093252124 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHANNA LYNN PARK Owner 808-315-1432 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: HI LMHC 427) |
| Enumeration Date | 2017-01-27 |
| Last Update Date | 2017-01-27 |