Organization
JONATHAN MOSS, CAREGIVING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN D MOSS LCSW (OWNER)
(503) 896-9628
Entity
Organization
Contact information
Practice address
110 ALAE ST, HILO, HI 96720-2507
(503) 896-9628
Mailing address
110 ALAE ST, HILO, HI 96720-2507
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
4194
HI
Other
Enumeration date
01/06/2017
Last updated
01/06/2017
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