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Organization
MENTALOHA LLC
Active
Organization
MENTALOHA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW JENKINS APRN (MANAGER)
(808) 725-2008
Entity
Organization
Contact information
Practice address
4210 HANAHAO PL STE 202, LIHUE, HI 96766-9036
(808) 725-2008
(808) 461-7098
Mailing address
4144 AIKEPA ST, LIHUE, HI 96766-8131
(808) 855-5775
(808) 461-7098
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
12/06/2022
Last updated
12/06/2022
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