Organization
SMALL KINE POLYNESIAN
Active
Organization
SMALL KINE POLYNESIAN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOE WILSON (SOCIAL WORKER)
(808) 457-9897
Entity
Organization
Contact information
Practice address
55-025 LANIHULI ST, LAIE, HI 96762-1225
(808) 457-9897
Mailing address
55-025 LANIHULI ST, LAIE, HI 96762-1225
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
HI
Other
Enumeration date
04/27/2012
Last updated
04/27/2012
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