Individual
MR. NORRIS LAYNE DELOSTRICO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1786 KINOOLE ST, HILO, HI 96720-5245
(808) 959-5855
Mailing address
PO BOX 54, MOUNTAIN VIEW, HI 96771-0054
(808) 960-6196
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
03/11/2020
Last updated
03/11/2020
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