Healthcare Provider Details

I. General information

NPI: 1902615586
Provider Name (Legal Business Name): LOKAHI TREATMENT CENTERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/07/2025
Last Update Date: 01/07/2025
Certification Date: 01/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 HUALANI ST. BLDG. 10, SUITE 195B
HILO HI
96720
US

IV. Provider business mailing address

400 HUALANI ST. BLDG. 10, SUITE 195B
HILO HI
96720
US

V. Phone/Fax

Practice location:
  • Phone: 808-969-9292
  • Fax:
Mailing address:
  • Phone: 808-969-9292
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: JAMAL WASAN
Title or Position: CEO
Credential: PSYD
Phone: 808-895-0444