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Organization

HAWAI'I DCR HEALTHCARE DIVISION

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ROMEY GLIDEWELL APRN (DIVISION ADMINISTRATOR)
(085) 878-3375
Entity
Organization

Contact information

Practice address
99-902 MOANALUA RD, AIEA, HI 96701-5605
(808) 485-1897
Mailing address
1177 ALAKEA ST STE 602, HONOLULU, HI 96813-2824
(808) 587-3375

Taxonomy

Speciality
Code
Description
License number
State
103TA0400X
Addiction (Substance Use Disorder) Psychologist
207Q00000X
Family Medicine Physician
Primary
2083A0300X
Addiction Medicine (Preventive Medicine) Physician
363LP0808X
Psychiatric/Mental Health Nurse Practitioner

Other

Enumeration date
02/19/2025
Last updated
02/19/2025
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