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General NPI Number Information
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NPI Number | 1043955040
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Entity Type | Organization
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Legal Business Name | KAIPUOKAUALOKU, LLC
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Dates
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Enumeration Date | 05/03/2022
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Last Update Date | 04/22/2025
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Provider Practice Location Address
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Address Line | 908 S J ST
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City | TACOMA
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State | WA
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Zip | 98405-4110
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Country | US
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Telephone | 808-518-9996
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Fax |
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Provider Business Mailing Address
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Address Line | 2265 PALOLO AVE APT B
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City | HONOLULU
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State | HI
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Zip | 96816-3147
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Country | US
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Telephone | 808-353-8554
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LEILANI MAXERA
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Credential | LCSW
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Telephone | 808-353-8554
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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 |
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License Number State |
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