Individual
MICHAEL JAMES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
47-343 LULANI ST, KANEOHE, HI 96744-4716
(678) 787-3632
Mailing address
47-343 LULANI ST, KANEOHE, HI 96744-4716
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
654506
GA
Other
Enumeration date
02/13/2014
Last updated
02/13/2014
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