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General NPI Number Information
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NPI Number | 1922405026
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Entity Type | Organization
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Legal Business Name | HORIZONS ACADEMY OF MAUI, INC.
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Dates
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Enumeration Date | 12/04/2014
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Last Update Date | 05/20/2022
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Provider Practice Location Address
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Address Line | 2680 WAI WAI PLACE
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City | KIHEI
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State | HI
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Zip | 96753
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Country | US
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Telephone | 808-575-2954
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Fax | 808-874-8192
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Provider Business Mailing Address
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Address Line | PO BOX 171
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City | KIHEI
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State | HI
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Zip | 96753-0171
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Country | US
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Telephone | 206-575-2954
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Fax | 808-874-8192
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Authorized Official
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Title or Position | OPERATIONS DIRECTOR
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Name | CRYSTAL THOMAS
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Credential |
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Telephone | 808-575-2954
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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 | 1-07-3851
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License Number State | HI
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