Organization
EFFECTIVE CHANGE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MATTHEW DOUGLAS BRITTAIN LCSW (OWNER)
(808) 934-7566
Entity
Organization
Contact information
Practice address
56 WAIANUENUE AVE, HILO, HI 96720-2474
(808) 934-7566
(808) 934-9442
Mailing address
PO BOX 1038, KURTISTOWN, HI 96760-1038
(808) 934-7566
(808) 934-9442
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
W4094131601
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
24819201
—
HI
Enumeration date
11/08/2010
Last updated
11/08/2010
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