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General NPI Number Information
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NPI Number | 1306604194
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Entity Type | Organization
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Legal Business Name | ACCELERATED REAL ESTATE INVESTMENT CORP
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Dates
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Enumeration Date | 03/07/2024
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Last Update Date | 03/07/2024
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Provider Practice Location Address
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Address Line | 225 QUEEN ST APT 7D
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City | HONOLULU
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State | HI
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Zip | 96813-4657
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Country | US
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Telephone | 877-678-1774
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Fax |
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Provider Business Mailing Address
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Address Line | 244 5TH AVE STE 2774
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City | NEW YORK
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State | NY
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Zip | 10001-7604
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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 | EXECUTIVE DIRECTOR/MENTAL HEALTH C.
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Name | ILIJHA-ESRAEL BASTIEN
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Credential | LPC
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Telephone | 877-678-1774
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225XM0800X
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Taxonomy Name | Mental Health Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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