# COMMUNITY CLINIC OF MAUI, INC.

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Malama I Ke Ola Health Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1528042561
- **Authorized official:** JOHN VAZ (CHIEF EXECUTIVE OFFICER)
- **Authorized official phone:** (808) 872-4018

## Contact information

- **Practice address:** 1881 NANI STREET, WAILUKU, HI 96793
- **Practice address phone:** (808) 872-4006
- **Practice address fax:** (808) 495-0026
- **Mailing address:** 1881 NANI STREET, WAILUKU, HI 96793-1811
- **Mailing address phone:** (808) 871-7772
- **Mailing address fax:** (808) 872-4029

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QC1500X | Community Health Clinic/Center | — | NULL | Yes |
| 261QF0400X | Federally Qualified Health Center (FQHC) | — | NULL | — |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | — |

## Other

- **Enumeration date:** 12/02/2005
- **Last updated:** 11/08/2024