Healthcare Provider Details

I. General information

NPI: 1063557700
Provider Name (Legal Business Name): HOPE IN THE NAME OF CHRIST
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

87-669 MANUAIHUE ST
WAIANAE HI
96792-3268
US

IV. Provider business mailing address

87-669 MANUAIHUE ST
WAIANAE HI
96792-3268
US

V. Phone/Fax

Practice location:
  • Phone: 808-230-2445
  • Fax: 808-668-9251
Mailing address:
  • Phone: 808-230-2445
  • Fax: 808-668-9251

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateHI

VIII. Authorized Official

Name: MRS. DAE HELEN LECKIE
Title or Position: EXECUTIVE DIRECTOR
Credential: LCMSW
Phone: 808-398-8231