Healthcare Provider Details

I. General information

NPI: 1356502066
Provider Name (Legal Business Name): BEHAVIOR ANALYSIS NO KA OI INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2008
Last Update Date: 07/20/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

564 SOUTH STREET
HONOLULU HI
96813-5013
US

IV. Provider business mailing address

564 SOUTH STREET
HONOLULU HI
96813-5013
US

V. Phone/Fax

Practice location:
  • Phone: 808-591-1173
  • Fax: 808-591-1174
Mailing address:
  • Phone: 808-591-1173
  • Fax: 808-591-1174

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number1-00-0056
License Number State

VIII. Authorized Official

Name: DR. CHRISTINE KIM WALTON
Title or Position: EXECUTIVE DIRECTOR
Credential: PHD, BCBA-D
Phone: 808-591-1173