Healthcare Provider Details

I. General information

NPI: 1023846615
Provider Name (Legal Business Name): HAWAIIAN HEALING ABA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2024
Last Update Date: 07/24/2024
Certification Date: 07/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1132 BISHOP ST UNIT 908
HONOLULU HI
96813-2886
US

IV. Provider business mailing address

1132 BISHOP ST UNIT 908
HONOLULU HI
96813-2886
US

V. Phone/Fax

Practice location:
  • Phone: 434-610-9856
  • Fax: 757-586-5055
Mailing address:
  • Phone: 434-610-9856
  • Fax: 757-586-5055

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DELONTE JONES
Title or Position: CEO
Credential: BCBA
Phone: 434-610-9856