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Organization

BOBBY BENSON CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JEFFRIE WAGNER (EXECUTIVE DIRECTOR)
(808) 293-7555
Entity
Organization

Contact information

Practice address
56-660 KAMEHAMEHA HWY, KAHUKU, HI 96731-2210
(808) 293-7555
(808) 293-7196
Mailing address
56-660 KAMEHAMEHA HWY, KAHUKU, HI 96731-2210
(808) 293-7555
(808) 293-7196

Taxonomy

Speciality
Code
Description
License number
State
3245S0500X
Children's Substance Abuse Rehabilitation Facility
Primary
53-STF
HI

Other

Enumeration date
12/04/2006
Last updated
08/22/2020
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