# MENTALOHA LLC

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

## Provider details

- **NPI number:** 1881305357
- **Authorized official:** MATTHEW JENKINS APRN (MANAGER)
- **Authorized official phone:** (808) 725-2008

## Contact information

- **Practice address:** 4210 HANAHAO PL STE 202, LIHUE, HI 96766-9036
- **Practice address phone:** (808) 725-2008
- **Practice address fax:** (808) 461-7098
- **Mailing address:** 4144 AIKEPA ST, LIHUE, HI 96766-8131
- **Mailing address phone:** (808) 855-5775
- **Mailing address fax:** (808) 461-7098

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 12/06/2022
- **Last updated:** 12/06/2022