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General NPI Number Information
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NPI Number | 1467166405
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Entity Type | Organization
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Legal Business Name | HEALTH OF OHANA MIGRATION EVALUATION SERVICES (HOME), LLC
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Dates
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Enumeration Date | 01/12/2023
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Last Update Date | 01/12/2023
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Provider Practice Location Address
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Address Line | 1600 KAPIOLANI BLVD STE 1306
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City | HONOLULU
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State | HI
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Zip | 96814-3805
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Country | US
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Telephone | 808-683-9678
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Fax |
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Provider Business Mailing Address
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Address Line | 1600 KAPIOLANI BLVD STE 1306
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City | HONOLULU
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State | HI
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Zip | 96814-3805
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Country | US
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Telephone | 808-683-9678
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Fax |
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Authorized Official
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Title or Position | LICENSED CLINICAL PSYCHOLOGIST
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Name | MATTHIAS DARRICARRERE
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Credential | PSYD
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Telephone | 808-683-9678
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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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