Organization
NORTH HAWAII CHILD DEVELOPMENT PROGRAM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER L DE COSTA PHD, MFT, CSAC (PROGRAM MANAGER)
(808) 885-0086
Entity
Organization
Contact information
Practice address
64-1032 MAMALAHOA HWY, SUITE 204, KAMUELA, HI 96743-8441
(808) 885-0086
(808) 885-8054
Mailing address
64-1032 MAMALAHOA HWY, SUITE 204, KAMUELA, HI 96743-8441
(808) 885-0086
(808) 885-8054
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64642403
—
HI
Enumeration date
06/08/2012
Last updated
06/08/2012
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