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Organization

HEAVENLY STAR LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
RENA MAE NALANI TAKUSHI LCSW (LICENSED CLINICAL SOCIAL WORKER)
(808) 781-7984
Entity
Organization

Contact information

Practice address
99-124 KOHOMUA ST, 15C, AIEA, HI 96701-3876
(808) 781-7984
Mailing address
99-124 KOHOMUA ST, 15C, AIEA, HI 96701-3876
(808) 781-7984

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
4054
HI

Other

Enumeration date
12/31/2015
Last updated
12/31/2015
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