MEDICARE: LOKAHI TREATMENT CENTERS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor		HI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1548210347	OTHER	HI	BISSET NPI
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	1427129196	OTHER	HI	WASAN NPI

General Provider Information

NPI Number	:	1073674602
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LOKAHI TREATMENT CENTERS

Provider Business Mailing Address
First Line	:	PO BOX 383401
Second Line	:
City	:	WAIKOLOA
State	:	HI
Zip	:	96738-3401
Country	:	US
Telephone Number	:	808-883-0922
Fax Number	:	808-883-1022

Provider Business Practice Location Address
First Line	:	68-1845 WAIKOLOA ROAD
Second Line	:	WAIKOLOA HIGHLANDS SHOPPING CENTER SUITE 224B
City	:	WAIKOLOA
State	:	HI
Zip	:	96738
Country	:	US
Telephone Number	:	808-883-0922
Fax Number	:	808-883-1022

Authorized Official
Title or Position	:	CEO
Name	:	DR. JAMAL F. WASAN
Credential	:	PHD, CSAC
Telephone Number	:	808-883-0922

Provider Enumeration Date	:	12/13/2006
Last Update Date	:	07/21/2022

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Directions to “LOKAHI TREATMENT CENTERS ” Practice Location

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