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General NPI Number Information
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NPI Number | 1578063251
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Entity Type | Organization
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Legal Business Name | KULEANA CARE LLC
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Dates
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Enumeration Date | 02/19/2018
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Last Update Date | 09/27/2021
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Provider Practice Location Address
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Address Line | 400 ALA MAKANI ST
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City | KAHULUI
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State | HI
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Zip | 96732-3533
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Country | US
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Telephone | 808-793-2005
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 306
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City | KULA
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State | HI
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Zip | 96790-0306
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Country | US
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Telephone | 808-927-4927
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR/OWNER
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Name | CRYSTAL M ROLLINS
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Credential | BCBA
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Telephone | 808-793-2005
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | 194
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License Number State | HI
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