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Organization
KAHALA CLINIC INTENSIVE TREATMENT PROGRAM
Active
Organization
KAHALA CLINIC INTENSIVE TREATMENT PROGRAM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JASON RICHARD KEIFER MD (PRESIDENT)
(808) 888-5228
Entity
Organization
Contact information
Practice address
4211 WAIALAE AVE STE 208, HONOLULU, HI 96816-5312
(808) 888-5228
(808) 732-6433
Mailing address
4211 WAIALAE AVE STE 208, HONOLULU, HI 96816-5312
(808) 888-5228
(808) 732-6433
Taxonomy
Speciality
Code
Description
License number
State
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
GE-090-260-8896-01
HI
Other
Enumeration date
08/12/2017
Last updated
07/21/2022
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