# COMMUNITY CLINIC OF MAUI, INC.

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** COMMUNITY CLINIC OF MAUI, INC.
- **Other names:** Malama I Ke Ola Health Center
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1619721263
- **Legal business name:** COMMUNITY CLINIC OF MAUI, INC.
- **Authorized official:** JOHN R VAZ (CEO)
- **Authorized official phone:** (808) 871-7772

## Contact information

- **Practice address:** 10 HOOHUI RD, LAHAINA, HI 96761-9256
- **Practice address phone:** (808) 871-7772
- **Practice address fax:** (808) 872-4029
- **Mailing address:** 1881 NANI ST, 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:** 04/11/2024
- **Last updated:** 04/11/2024