Basic Information
| Provider Information | |||||||||
| NPI: | 1356766364 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | ALOHA HOUSE, INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1787 WILI PA LOOP | ||||||||
| Address2: | |||||||||
| City: | WAILUKU | ||||||||
| State: | HI | ||||||||
| PostalCode: | 967931280 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8085798414 | ||||||||
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| Practice Location | |||||||||
| Address1: | 270 HOOKAHI ST | ||||||||
| Address2: | |||||||||
| City: | WAILUKU | ||||||||
| State: | HI | ||||||||
| PostalCode: | 967931466 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8085798414 | ||||||||
| FaxNumber: | 8082421660 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/27/2014 | ||||||||
| LastUpdateDate: | 02/27/2014 | ||||||||
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| AuthorizedOfficialLastName: | CUNNINGHAM | ||||||||
| AuthorizedOfficialFirstName: | JUD | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 8085798414 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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| AuthorizedOfficialCredential: | MSW | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251B00000X | Y | Agencies | Case Management |
No ID Information.