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Organization
MANGO FOUNDATION, INC.
Active
Organization
MANGO FOUNDATION, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY DUERLER (BOARD OF DIRECTOR)
(808) 351-6836
Entity
Organization
Contact information
Practice address
64-1032 MAMALAHOA HWY, SUITE 306, KAMUELA, HI 96743-8441
(808) 769-5010
Mailing address
64-1032 MAMALAHOA HWY, SUITE 306, KAMUELA, HI 96743-8441
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
NULL
Other
Enumeration date
11/14/2016
Last updated
11/14/2016
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