# LIFESTYLE MEDICINE CENTER OF HAWAII, LLC

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

## Provider details

- **NPI number:** 1538740766
- **Authorized official:** APRIL M JOHNSON (DIRECTOR)
- **Authorized official phone:** (808) 854-1162

## Contact information

- **Practice address:** 75-1027 HENRY ST STE 110, KAILUA KONA, HI 96740-3154
- **Practice address phone:** (808) 769-5225
- **Practice address fax:** (808) 769-5099
- **Mailing address:** 75-1027 HENRY ST STE 110, KAILUA KONA, HI 96740-3154
- **Mailing address phone:** (808) 769-5225
- **Mailing address fax:** (808) 769-5099

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163WC3500X | Cardiac Rehabilitation Registered Nurse | — | NULL | Yes |
| 163WC3500X | Cardiac Rehabilitation Registered Nurse | — | — | Yes |

## Other

- **Enumeration date:** 04/19/2021
- **Last updated:** 04/19/2021