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Organization
HALE KIPA, INC.
Active
Organization
HALE KIPA, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. VENUS VENUS ROSETE-MEDEIROS (CEO)
(808) 589-1829
Entity
Organization
Contact information
Practice address
91-2128 OLD FT WEAVER RD, EWA BEACH, HI 96706-1911
(808) 589-1829
(808) 589-2610
Mailing address
91-2128 OLD FT WEAVER RD, EWA BEACH, HI 96706-1911
(808) 589-1829
(808) 589-2610
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
W2005550002
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
W2005550002
HAWAII TAX ID
HI
Enumeration date
06/18/2007
Last updated
05/11/2023
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