Healthcare Provider Details
I. General information
NPI: 1356214704
Provider Name (Legal Business Name): OHANA MANA NETWORK FOR NEUROMETABOLIC WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/23/2025
Last Update Date: 10/11/2025
Certification Date: 10/11/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1511 NUUANU AVE APT 1237
HONOLULU HI
96817-3713
US
IV. Provider business mailing address
1309 COFFEEN AVE STE 1200
SHERIDAN WY
82801-5777
US
V. Phone/Fax
- Phone: 808-295-4021
- Fax: 808-666-9212
- Phone: 307-335-4968
- Fax: 307-312-3277
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM2500X |
| Taxonomy | Medical Specialty Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
TIFFANY
HOKE
Title or Position: FOUNDER, CEO, MEDICAL DIRECTOR
Credential: DNP, APRN-RX, AGACNP
Phone: 307-335-4968