Organization
BOBBY BENSON CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFF WAGNER MFT (DIRECTOR)
(808) 293-7555
Entity
Organization
Contact information
Practice address
56-660 KAMEHAMEHA HWY, KAHUKU, HI 96731-2210
(808) 293-7555
(808) 293-7196
Mailing address
56-660 KAMEHAMEHA HIGHWAY, KAHUKU, HI 96731
(808) 293-7555
(808) 293-7196
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
320800000X
HI
Other
Enumeration date
08/26/2008
Last updated
08/26/2008
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