=====================================================
General NPI Number Information
=====================================================
NPI Number | 1689224024
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ACCESS TO CARE AMERICA
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/18/2019
-----------------------------------------------------
Last Update Date | 09/18/2019
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 500 ALA MOANA BLVD
-----------------------------------------------------
City | HONOLULU
-----------------------------------------------------
State | HI
-----------------------------------------------------
Zip | 96813-4920
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 808-353-8413
-----------------------------------------------------
Fax | 808-427-3471
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3010 VISTA PL
-----------------------------------------------------
City | HONOLULU
-----------------------------------------------------
State | HI
-----------------------------------------------------
Zip | 96822-1641
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 808-219-0456
-----------------------------------------------------
Fax | 808-427-3471
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT AND FOUNDER
-----------------------------------------------------
Name | MR. CHRISTOPHER MATTHEW KNIGHTSBRIDGE
-----------------------------------------------------
Credential | M.A.
-----------------------------------------------------
Telephone | 808-219-0456
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QM0850X
-----------------------------------------------------
Taxonomy Name | Adult Mental Health Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 261Q00000X
-----------------------------------------------------
Taxonomy Name | Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------