Organization
BEACON OF LASTING CHANGE, LLC
Active
Organization
BEACON OF LASTING CHANGE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MAITA MARKS LMFT (MANAGER)
(808) 600-1132
Entity
Organization
Contact information
Practice address
438 HOBRON LN STE 311, HONOLULU, HI 96815-1229
(808) 600-1132
Mailing address
5984 GANNET AVE, EWA BEACH, HI 96706-3239
(808) 600-1132
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
12/13/2021
Last updated
12/13/2021
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