Organization
NOVA LUNA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MICHELLE VILLANTI LCSW (CLINICIAN)
(808) 870-9886
Entity
Organization
Contact information
Practice address
1152 MAKAWAO AVE, MAKAWAO, HI 96768-9448
(808) 870-9886
Mailing address
1135 MAKAWAO AVE PMB 340, MAKAWAO, HI 96768-7403
(808) 870-9886
Taxonomy
Speciality
Code
Description
License number
State
283Q00000X
Psychiatric Hospital
Primary
LCSW3028
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
259812
HMSA
HI
Enumeration date
05/08/2007
Last updated
08/22/2020
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