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General NPI Number Information
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NPI Number | 1316797459
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Entity Type | Organization
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Legal Business Name | THE MANA COLLECTIVE LLC
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Dates
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Enumeration Date | 03/22/2024
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Last Update Date | 03/22/2024
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Provider Practice Location Address
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Address Line | 66-437 KAMEHAMEHA HWY UNIT 125
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City | HALEIWA
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State | HI
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Zip | 96712-3007
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Country | US
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Telephone | 808-212-9922
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1084
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City | HALEIWA
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State | HI
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Zip | 96712-1084
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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 | CLINICAL SUPERVISOR
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Name | MRS. LINDSEY HOFFMAN
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Credential | LCSW
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Telephone | 847-494-3540
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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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 | 146N00000X
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Taxonomy Name | Basic Emergency Medical Technician
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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