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General NPI Number Information
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NPI Number | 1851253306
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Entity Type | Organization
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Legal Business Name | TAUTUA
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Dates
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Enumeration Date | 12/02/2025
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Last Update Date | 12/02/2025
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Provider Practice Location Address
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Address Line | KOREA HOUSE, ROUTE 1 EASTERN DISTRICT
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City | PAGO PAGO
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State | AS
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Zip | 96799
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Country | US
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Telephone | 684-782-8255
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1270
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City | PAGO PAGO
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State | AS
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Zip | 96799-1270
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Country | US
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Telephone | 684-782-8255
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Fax |
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | PRINCE FAUMUINA
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Credential |
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Telephone | 684-782-8255
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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