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General NPI Number Information
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NPI Number | 1043599350
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Entity Type | Organization
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Legal Business Name | AMAZING BEHAVING LLC
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Dates
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Enumeration Date | 08/04/2011
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Last Update Date | 08/04/2011
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Provider Practice Location Address
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Address Line | 417 KAIMAKE LOOP
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City | KAILUA
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State | HI
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Zip | 96734-2021
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Country | US
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Telephone | 808-295-2453
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 342012
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City | KAILUA
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State | HI
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Zip | 96734-8996
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. JOSHUA H FOUTS
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Credential | PH.D., BCBA
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Telephone | 808-295-2453
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 1-09-5745
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License Number State | HI
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