Healthcare Provider Details

I. General information

NPI: 1194854844
Provider Name (Legal Business Name): THE ARC IN HAWAII
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/05/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

91-824 HANAKAHI ST # B
EWA BEACH HI
96706-2914
US

IV. Provider business mailing address

3989 DIAMOND HEAD RD
HONOLULU HI
96816-4413
US

V. Phone/Fax

Practice location:
  • Phone: 808-737-7995
  • Fax: 808-732-9531
Mailing address:
  • Phone: 808-737-7995
  • Fax: 808-732-9531

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License NumberIMR 31
License Number StateHI

VIII. Authorized Official

Name: COLLEEN KOJIMA
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 808-737-7995