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General NPI Number Information
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NPI Number | 1740929108
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Entity Type | Organization
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Legal Business Name | SPILL THE TEA CAFE
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Dates
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Enumeration Date | 06/02/2022
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Last Update Date | 06/02/2022
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Provider Practice Location Address
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Address Line | 1034 QUEEN ST FL 2
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City | HONOLULU
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State | HI
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Zip | 96814-4116
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Country | US
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Telephone | 808-797-4970
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Fax |
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Provider Business Mailing Address
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Address Line | 47-283 HUI IWA ST APT A
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City | KANEOHE
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State | HI
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Zip | 96744-4359
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Country | US
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Telephone | 808-364-7592
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. KRIZIA LUGARO
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Credential |
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Telephone | 808-797-4970
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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