Healthcare Provider Details

I. General information

NPI: 1346793114
Provider Name (Legal Business Name): DEBRA BAYER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2016
Last Update Date: 12/06/2022
Certification Date: 12/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1325 S KIHEI RD STE 215
KIHEI HI
96753
US

IV. Provider business mailing address

1325 S KIHEI RD STE 215
KIHEI HI
96753-8145
US

V. Phone/Fax

Practice location:
  • Phone: 808-243-3200
  • Fax: 888-238-8697
Mailing address:
  • Phone: 808-243-3200
  • Fax: 888-238-8697

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: DEBI CHAPMAN
Title or Position: PRESIDENT/AUTHORIZED OFFICIAL
Credential:
Phone: 808-243-3200