Organization
COMMUNITY CLINIC OF MAUI, INC.
Active
Organization
COMMUNITY CLINIC OF MAUI, INC.
Active
Parent organization
COMMUNITY CLINIC OF MAUI, INC.
Other names
Malama I Ke Ola Health Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
COMMUNITY CLINIC OF MAUI, INC.
Authorized official
JOHN R VAZ MD (CHIEF EXECUTIVE OFFICER)
(808) 871-7772
Entity
Organization
Contact information
Practice address
250 E LIPOA ST, KIHEI, HI 96753-8125
(808) 871-7772
Mailing address
1881 NANI ST, WAILUKU, HI 96793-1811
(808) 871-7772
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
261QS1000X
Student Health Clinic/Center
—
—
Other
Enumeration date
05/09/2023
Last updated
05/09/2023
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