Organization
SANDAL GAP COMPREHENSIVE SERVICES
Active
Other names
Sandal Gap Comprehensive Services
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE JOHNSON (CEO)
(808) 425-0195
Entity
Organization
Contact information
Practice address
126 AIKAHI LOOP, KAILUA, HI 96734-1642
(808) 425-0195
Mailing address
126 AIKAHI LOOP, KAILUA, HI 96734-1642
(808) 425-0195
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
102L00000X
Psychoanalyst
—
—
103K00000X
Behavior Analyst
Primary
—
—
1041C0700X
Clinical Social Worker
—
—
106S00000X
Behavior Technician
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
10/11/2022
Last updated
03/15/2023
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