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NPI 1962773176

NPI 1962773176 : UNITED CEREBRAL PALSY ASSOCIATION OF HAWAII : HONOLULU, HI

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General NPI Number Information
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    NPI Number           |    1962773176
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    Entity Type          |    Organization 
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    Legal Business Name  |    UNITED CEREBRAL PALSY ASSOCIATION OF HAWAII 
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Dates
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    Enumeration Date     |    01/19/2012
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    Last Update Date     |    01/19/2012
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Provider Practice Location Address
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    Address Line         |    414 KUWILI ST SUITE 105
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    City                 |    HONOLULU
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    State                |    HI
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    Zip                  |    96817-5362
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    Country              |    US
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    Telephone            |    808-532-6744
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    Fax                  |    808-532-6747
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Provider Business Mailing Address
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    Address Line         |    414 KUWILI ST SUITE 105
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    City                 |    HONOLULU
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    State                |    HI
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    Zip                  |    96817-5362
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    Country              |    US
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    Telephone            |    808-532-6744
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    Fax                  |    808-532-6747
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Authorized Official
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    Title or Position    |    EXECUTIVE DIRECTOR
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    Name                 |    MS. DONNA  FOUTS 
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    Credential           |    
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    Telephone            |    808-532-6744
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    252Y00000X
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    Taxonomy Name        |    Early Intervention Provider Agency
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    License Number       |    
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    License Number State |    
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