PROVIDENCE LIVING LLC (NPI# 1003413097) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003413097 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE LIVING LLC |
| Other Organization Name | PROVIDENCE TREATMENT |
| Practice Address |
1188 Bishop St Ste 1008 Honolulu HI 96813-3304 |
| Practice Telephone | 8084456780 |
| Practice Fax Number | 8883739844 |
| Mailing Telephone | 8084456780 |
| Mailing Fax Number | 8883739844 |
| Enumeration Date | 2020-10-03 |
| Last Update Date | 2020-10-09 |
| Authorized Official Name | DR. WILLIAM J HERAN (CEO) |
| Authorized Official Telephone | 8084456780 |
| Authorized Official Credential | PHD, LCSW |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| Providence Treatment | Doing Business As Name - Organization |
| Providence Treatment | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962965145 | Providence Living LLC | Substance Abuse Rehabilitation Facility | 1528 Walnut St Ste 1410, Philadelphia, PA 19102-3610 | 2019-04-13 |
| 1053874230 | Providence Living LLC | Substance Abuse Rehabilitation Facility | 355 Lancaster Ave Ste 303, Haverford, PA 19041-1502 | 2019-04-13 |
| 1730562711 | Providence Living LLC | Counselor | 280 N Providence Rd Ste 2, Media, PA 19063-3525 | 2015-07-08 |
| Street Address |
1188 BISHOP ST STE 1008 |
| City | HONOLULU |
| State | HI |
| Zip Code | 96813-3304 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952902322 | Kawehi Hanohano-navarro | Behavior Technician | Attn: Behavioral Health Works 500 Ala Moana Blvd. Suit, Honolulu, HI 96813 | 2020-11-03 |
| 1659971489 | University Clinical Education & Research Associates | Clinical Medical Laboratory | 651 Ilalo Street, Bioscience Bldg Rm 333, Honolulu, HI 96813 | 2020-10-30 |
| 1700490919 | Tiana Taylor Williams | Behavior Technician | 7 Waterfront Plaza, 500 Ala Moana Blvd, Suite 400, Honolulu, HI 96813 | 2020-09-04 |
| 1134761109 | Florence Kwitonda | Behavior Technician | 500 Ala Moana Blvd., Suite 400, Honolulu, HI 96813 | 2019-10-11 |
| 1629629373 | Alyssa Niel Gethings | Behavior Technician | Attn: Behavioral Health Works 500 Ala Moana Blvd. Suite, Honolulu, HI 96813 | 2019-09-24 |
| 1851949069 | Miho Camarata | Behavior Technician | Attn: Behavioral Health Works 500 Ala Moana Blvd, Suite 400, Honolulu, HI 96813 | 2019-08-30 |
| 1326696519 | Chanelle Ashley Ramos | Behavior Technician | Attn: Behavioral Health Works 500 Ala Moana Blvd., Suite 400, Honolulu, HI 96813 | 2019-08-30 |
| 1568022580 | Fataly Willy | Behavioral Analyst | 500 Alamoana Blvd #7-400, Honolulu, HI 96813 | 2019-06-20 |
| 1538624069 | Galaxy Urgent Care Inc | Internal Medicine | 50 South Beretania St, C210 B, Honolulu, HI 96813 | 2019-02-08 |
| 1376010124 | Queen's Development Corporation and Subsidiaries | Clinic/Center | 400 Keawe Street, Suite 100, Honolulu, HI 96813 | 2018-10-30 |
| Find all providers in zip 96813 | ||||
| Taxonomy Code | 324500000X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |
| Notes: [7/1/2003: modified title, modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578689816 | Kline-welsh Behavioral Health Fondation | Substance Abuse Rehabilitation Facility | 1240 Sand Island Pkwy, Honolulu, HI 96819-4315 | 2007-03-21 |
| 1871660902 | Salvation Army Addiction Treatment Services | Substance Abuse Rehabilitation Facility | 3624 Waokanaka St, Honolulu, HI 96817-5224 | 2006-11-30 |
| 1235329897 | Paradise Recovery, LLC | Substance Abuse Rehabilitation Facility | 7017 Kalanianaole Hwy, Honolulu, HI 96825-2007 | 2007-07-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215474317 | New Leaf Treatment Centre LLC | Substance Abuse Rehabilitation Facility | 152 Lakeview Circle, Wahiawa, HI 96786 | 2017-01-26 |
| 1346793114 | Debra Bayer Inc | Substance Abuse Rehabilitation Facility | 1325 S Kihei Rd Ste 215, Kihei, HI 96753 | 2016-07-28 |
| 1699065599 | The Scott Recovery Retreat | Substance Abuse Rehabilitation Facility | 4030 Pali Moana Place, Kilauea, HI 96754 | 2011-04-12 |
| 1598902744 | Narconon Hawaii | Substance Abuse Rehabilitation Facility | 90-1011 Lexington Avenue, Kapolei, HI 76707 | 2009-01-09 |
| 1194883553 | Ho'omau Ke Ola | Substance Abuse Rehabilitation Facility | 85-761 Farrington Hwy, Waianae, HI 96792-2463 | 2006-12-05 |
| 1740358118 | The Alcoholic Rehabilitation Services of Hawaii Inc | Substance Abuse Rehabilitation Facility | 45-845 Pookela St, Kaneohe, HI 96744-5700 | 2006-12-01 |
| 1740629310 | Jeffrey James Baumann | Substance Abuse Rehabilitation Facility | 56-660 Kamehameha Hwy, Kahuku, HI 96731-2210 | 2013-06-17 |
| 1457642076 | Aloha House | Substance Abuse Rehabilitation Facility | 200 Ike Dr, Makawao, HI 96768-9718 | 2011-04-29 |
| 1194054296 | Morris Angus Graham | Substance Abuse Rehabilitation Facility | 56-660 Kamehameha Hwy, Kahuku, HI 96731-2210 | 2009-12-18 |
Please comment or provide details below to improve the information on PROVIDENCE LIVING LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.