Organization
STATE OF HAWAII DEPARTMENT OF HEALTH
Active
Parent organization
STATE OF HAWAII, DEPARTMENT OF HEALTH
Other names
Maui CCBHC - Kahului
Organization subpart
Yes
Provider details
NPI number
Legal business name
STATE OF HAWAII, DEPARTMENT OF HEALTH
Authorized official
TROY ALAN FREITAS (PROGRAM HEALTH BRANCH MANAGER)
(808) 478-6207
Entity
Organization
Contact information
Practice address
53 S PUUNENE AVE STE 105, KAHULUI, HI 96732-2192
(808) 658-5765
(808) 984-2155
Mailing address
PO BOX 3378, HONOLULU, HI 96801-3378
(808) 590-7320
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
—
—
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QC1500X
Community Health Clinic/Center
—
—
Other
Enumeration date
07/02/2024
Last updated
07/02/2024
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