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General NPI Number Information
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NPI Number | 1356698559
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Entity Type | Organization
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Legal Business Name | STARR (SOBRIETY TRAINING & RECOVERY RESOURCES) INC.
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Dates
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Enumeration Date | 08/07/2012
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Last Update Date | 08/07/2012
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Provider Practice Location Address
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Address Line | 40 AULIKE ST STE 217
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City | KAILUA
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State | HI
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Zip | 96734-2753
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Country | US
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Telephone | 808-722-2437
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Fax | 808-263-1920
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Provider Business Mailing Address
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Address Line | 111 HEKILI ST # A1603
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City | KAILUA
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State | HI
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Zip | 96734-2800
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Country | US
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Telephone | 808-722-2437
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Fax | 808-263-1920
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Authorized Official
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Title or Position | OWNER
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Name | PROF. DESRAE K. KAHALE
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Credential | MHC
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Telephone | 808-722-2437
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 200
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License Number State | HI
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