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Organization
COMMUNITY CLINIC OF MAUI, INC.
Active
Organization
COMMUNITY CLINIC OF MAUI, INC.
Active
Parent organization
COMMUNITY CLINIC OF MAUI, INC.
Other names
Malama I Ke Ola Health Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
COMMUNITY CLINIC OF MAUI, INC.
Authorized official
BETTY JANE OTT (CHIEF EXECUTIVE OFFICER)
(808) 872-4018
Entity
Organization
Contact information
Practice address
1881 NANI ST, WAILUKU, HI 96793-1811
(808) 871-7772
Mailing address
1881 NANI ST, WAILUKU, HI 96793-1811
(808) 871-7772
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
NULL
Other
Enumeration date
10/22/2020
Last updated
10/22/2020
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