Organization
LEEWARD EARLY CHILDHOOD SERVICES PROGRAM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MAE M. BRACEROS (PROGRAM MANAGER)
(808) 453-6960
Entity
Organization
Contact information
Practice address
860 FOURTH ST, ROOM #150, PEARL CITY, HI 96782-3312
(808) 453-6960
(808) 453-6964
Mailing address
860 FOURTH ST, ROOM #150, PEARL CITY, HI 96782-3312
(808) 453-6960
(808) 453-6964
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64626802
—
HI
Enumeration date
12/21/2011
Last updated
12/21/2011
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