Organization
FIVE MOUNTAINS HAWAII, INC
Active
Other names
Kipuka o ke Ola
Organization subpart
No
Provider details
NPI number
Authorized official
CLAREN KUULEI KEALOHA-BEAUDET PSYD (CHIEF EXECUTIVE OFFICER)
(808) 885-5900
Entity
Organization
Contact information
Practice address
64-1035 MAMALAHO HWY STE F, KAMUELA, HI 96743-8440
(808) 885-5900
(808) 885-6900
Mailing address
PO BOX 818, KAMUELA, HI 96743-0818
(808) 885-5900
(808) 885-6900
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
—
—
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
813669
—
HI
Enumeration date
01/14/2014
Last updated
01/13/2022
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