MEDICARE: BOCHA, LLC

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	106S00000X	Behavior Technician
2	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1427702455
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BOCHA, LLC

Provider Business Mailing Address
First Line	:	1140 KAHAAPO LOOP
Second Line	:
City	:	KIHEI
State	:	HI
Zip	:	96753-5246
Country	:	US
Telephone Number	:	808-446-2712
Fax Number	:

Provider Business Practice Location Address
First Line	:	1367 S KIHEI RD
Second Line	:
City	:	KIHEI
State	:	HI
Zip	:	96753-5802
Country	:	US
Telephone Number	:	808-446-2712
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	BEAU LAUGHLIN
Credential	:
Telephone Number	:	808-446-2712

Provider Enumeration Date	:	02/08/2022
Last Update Date	:	02/08/2022

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Directions to “BOCHA, LLC ” Practice Location

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