# MARIMED FOUNDATION

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104192970
- **Authorized official:** MR. DANE GANES (QA AND HR DIRECTOR)
- **Authorized official phone:** (808) 380-9964

## Contact information

- **Practice address:** 47-292 AHAOLELO RD, KANEOHE, HI 96744-4803
- **Practice address phone:** (808) 239-2939
- **Mailing address:** 45-021 LIKEKE PL, KANEOHE, HI 96744-2426
- **Mailing address phone:** (808) 239-2939
- **Mailing address fax:** (808) 397-3179

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | — | — | Yes |

## Other

- **Enumeration date:** 03/27/2012
- **Last updated:** 03/27/2012