Organization
EXECUTIVE AND PROFESSIONAL SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VALERIE MELLE (MANAGER)
(808) 652-2684
Entity
Organization
Contact information
Practice address
4432 PAPALINA RD, KALAHEO, HI 96741
(808) 652-2684
Mailing address
PO BOX 488, KALAHEO, HI 96741-0488
(808) 652-2684
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
10/14/2022
Last updated
10/14/2022
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