| NPI | 1568841690 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CYNTHIA D FATA Manager 808-854-0436 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: HI MHC 358) |
| Enumeration Date | 2015-05-21 |
| Last Update Date | 2015-05-21 |