Healthcare Provider Details

I. General information

NPI: 1770814592
Provider Name (Legal Business Name): OHANA BEHAVIORAL CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2010
Last Update Date: 01/18/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1448 YOUNG ST STE 12
HONOLULU HI
96814-1865
US

IV. Provider business mailing address

1448 YOUNG ST STE 12
HONOLULU HI
96814-1865
US

V. Phone/Fax

Practice location:
  • Phone: 808-941-1800
  • Fax: 888-871-1150
Mailing address:
  • Phone: 808-941-1800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: CHEYENNE AKANA
Title or Position: LCSW, MANAGER
Credential:
Phone: 808-941-1800