Healthcare Provider Details

I. General information

NPI: 1114733870
Provider Name (Legal Business Name): SAIN MAMAU
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2024
Last Update Date: 12/09/2024
Certification Date: 12/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2634A LOWREY AVE
HONOLULU HI
96822-1675
US

IV. Provider business mailing address

758 KAPAHULU AVE, STE 100, 1099
HONOLULU HI
96816
US

V. Phone/Fax

Practice location:
  • Phone: 707-980-3310
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code282J00000X
TaxonomyReligious Nonmedical Health Care Institution
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LORINDA ARECHY
Title or Position: OPERATIONS DIRECTOR
Credential: MS, CCC-SLP
Phone: 707-980-3310