Healthcare Provider Details

I. General information

NPI: 1114571973
Provider Name (Legal Business Name): HOUSE OF BLESSINGS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2019
Last Update Date: 07/30/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

148 LAKEVIEW CIR
WAHIAWA HI
96786-1531
US

IV. Provider business mailing address

PO BOX 63136
EWA BEACH HI
96706-1081
US

V. Phone/Fax

Practice location:
  • Phone: 808-840-7939
  • Fax: 808-443-0945
Mailing address:
  • Phone: 808-840-7939
  • Fax: 808-443-0945

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: MS. MICHELE L UEMOTO-JOSEPH
Title or Position: OWNER/EXECUTIVE DIRECTOR
Credential:
Phone: 808-840-7939