Healthcare Provider Details

I. General information

NPI: 1437001963
Provider Name (Legal Business Name): INTEGRATION HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2026
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2460 OKA ST STE 201
KILAUEA HI
96754-5308
US

IV. Provider business mailing address

2460 OKA ST STE 201
KILAUEA HI
96754-5308
US

V. Phone/Fax

Practice location:
  • Phone: 808-855-0908
  • Fax:
Mailing address:
  • Phone: 808-855-0908
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: SA RAH
Title or Position: OWNER/MANAGER/NP
Credential: NP
Phone: 808-855-0908