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General NPI Number Information
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NPI Number | 1508574229
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Entity Type | Organization
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Legal Business Name | HOUSE OF HEALING HAWAII LLC
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Dates
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Enumeration Date | 11/10/2022
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Last Update Date | 12/10/2025
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Provider Practice Location Address
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Address Line | 1003 BISHOP ST STE 2700
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City | HONOLULU
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State | HI
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Zip | 96813-6475
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Country | US
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Telephone | 808-476-8983
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Fax | 808-736-0831
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Provider Business Mailing Address
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Address Line | 1003 BISHOP ST STE 2700 PMB 562
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City | HONOLULU
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State | HI
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Zip | 96813-6475
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Country | US
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Telephone | 808-476-8983
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Fax | 808-736-0831
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | SHENELLE MICOLE FOSTER
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Credential | LCSW
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Telephone | 808-476-8983
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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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