Healthcare Provider Details

I. General information

NPI: 1215892708
Provider Name (Legal Business Name): HINIA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/17/2025
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

176 MAMO ST STE 103
HILO HI
96720-2984
US

IV. Provider business mailing address

176 MAMO ST STE 103
HILO HI
96720-2984
US

V. Phone/Fax

Practice location:
  • Phone: 808-785-7624
  • Fax: 808-443-0131
Mailing address:
  • Phone: 808-785-7624
  • Fax: 808-443-0131

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: MISS LAUREL LABISTRE
Title or Position: OWNER AND LMT
Credential: LMT, CCST, ABT
Phone: 808-785-7624