| NPI | 1407321797 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEATHER LUSK Executive Director 808-521-2437 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health |
| Additional Taxonomies | 1041C0700X Social Worker Clinical |
| 101YA0400X Counselor Addiction (Substance Use Disorder) | |
| Enumeration Date | 2018-10-12 |
| Last Update Date | 2018-10-12 |