Organization
KINOHI MANA NUI SUPPORT SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEVERLYN BAQUIRING KANG (EXECUTIVE DIRECTOR/FOUNDER)
(808) 723-2738
Entity
Organization
Contact information
Practice address
1412 HOOHULU ST, PEARL CITY, HI 96782-2916
(808) 723-2738
Mailing address
1412 HOOHULU ST, PEARL CITY, HI 96782-2916
(808) 723-2738
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
251S00000X
Community/Behavioral Health Agency
—
—
310400000X
Assisted Living Facility
Primary
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
Other
Enumeration date
04/24/2024
Last updated
04/30/2024
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