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General NPI Number Information
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NPI Number | 1619325396
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Entity Type | Organization
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Legal Business Name | FAMILY PROGRAMS HAWAII
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Dates
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Enumeration Date | 06/02/2016
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Last Update Date | 06/02/2016
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Provider Practice Location Address
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Address Line | 250 VINEYARD ST
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City | HONOLULU
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State | HI
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Zip | 96813-2445
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Country | US
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Telephone | 808-521-9531
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Fax | 808-533-1018
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Provider Business Mailing Address
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Address Line | 250 VINEYARD ST
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City | HONOLULU
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State | HI
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Zip | 96813-2445
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Country | US
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Telephone | 808-521-9531
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Fax | 808-533-1018
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Authorized Official
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Title or Position | EXECUTIVE VICE PRESIDENT
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Name | MR. KEITH KUBOYAMA
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Credential | LCSW
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Telephone | 808-521-9531
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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 | 3175
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License Number State | HI
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