Healthcare Provider Details

I. General information

NPI: 1083149892
Provider Name (Legal Business Name): UNITED SELF HELP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/29/2017
Last Update Date: 04/29/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

277 OHUA AVE ROOM 205 H
HONOLULU HI
96815-6612
US

IV. Provider business mailing address

310 PAOAKALANI AVE
HONOLULU HI
96815-3738
US

V. Phone/Fax

Practice location:
  • Phone: 808-947-5558
  • Fax:
Mailing address:
  • Phone: 808-947-5558
  • Fax: 808-737-6405

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name: MR. WILLIAM SPURRIER BOWLES
Title or Position: EXECUTIVE DIRECTOR
Credential: MSW, CPRP, HCPS
Phone: 808-947-5558