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General NPI Number Information
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NPI Number | 1679800882
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Entity Type | Organization
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Legal Business Name | KA HALE POMAIKA'I
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Dates
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Enumeration Date | 11/09/2009
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Last Update Date | 11/09/2009
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Provider Practice Location Address
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Address Line | HC-01 BOX 372 KAMEHAMEHA V HWY
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City | UALAPU'E
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State | HI
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Zip | 96748
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Country | US
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Telephone | 808-558-8480
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1895
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City | KAUNAKAKAI
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State | HI
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Zip | 96748-1895
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | SHARI R LYNN
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Credential | M ED, CCS, CSAC
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Telephone | 808-558-8480
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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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