Healthcare Provider Details

I. General information

NPI: 1336034636
Provider Name (Legal Business Name): OHANA MUA, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2025
Last Update Date: 06/09/2025
Certification Date: 06/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1562 MOLEHU DR
HONOLULU HI
96818-1920
US

IV. Provider business mailing address

1562 MOLEHU DR
HONOLULU HI
96818-1920
US

V. Phone/Fax

Practice location:
  • Phone: 808-861-0810
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: REGINA CUMMINGS
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 808-861-0810