Organization
THERAPY SPACE LLC
Active
Other names
The Therapy Space, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
TALIESIN SUMNER-LONGBOY MSW (OWNER)
(808) 481-7283
Entity
Organization
Contact information
Practice address
RR 3 81766, PAHOA, HI 96778
(808) 481-7283
Mailing address
RR 3 BOX 81766, PAHOA, HI 96778
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
04/24/2024
Last updated
05/22/2024
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