Healthcare Provider Details

I. General information

NPI: 1134081292
Provider Name (Legal Business Name): INMATE INITIATIVE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/26/2025
Last Update Date: 11/26/2025
Certification Date: 11/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 NAMAUU PL
KIHEI HI
96753-9165
US

IV. Provider business mailing address

140 NAMAUU PL
KIHEI HI
96753-9165
US

V. Phone/Fax

Practice location:
  • Phone: 808-281-9515
  • Fax:
Mailing address:
  • Phone: 808-281-9515
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. VINCE WILLIAM RAZO
Title or Position: PRESIDENT
Credential:
Phone: 808-281-9515