KAHALA CLINIC INTENSIVE TREATMENT PROGRAM (NPI# 1306361241) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306361241 |
| Entity Type | Organization |
| Organization Name | KAHALA CLINIC INTENSIVE TREATMENT PROGRAM |
| Practice Address |
4211 Waialae Ave Ste 208 Honolulu HI 96816-5312 |
| Practice Telephone | (808) 888-5228 |
| Practice Fax Number | 8087326433 |
| Mailing Telephone | 8088885228 |
| Mailing Fax Number | 8087326433 |
| Enumeration Date | 2017-08-12 |
| Last Update Date | 2017-08-12 |
| Authorized Official Name | DR. JASON RICHARD KEIFER (PRESIDENT) |
| Authorized Official Telephone | 8088885228 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0855X |
Clinic/Center Specialization: Adolescent and Children Mental Health |
GE-090-260-8896- | HI | Ambulatory Health Care Facilities |
| Street Address |
4211 WAIALAE AVE STE 208 |
| City | HONOLULU |
| State | HI |
| Zip Code | 96816-5312 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831398148 | Josephine Pardenilla Horita | Psychiatry & Neurology | 4211 Waialae Ave Ste 208, Honolulu, HI 96816-5312 | 2007-07-16 |
| 1245758549 | Josephine P. Horita, D.o. LLC | Clinic/Center | 4211 Waialae Ave Ste 208, Honolulu, HI 96816-5312 | 2017-09-07 |
| 1720362569 | Candice Lacey Barnett | General Practice | 4211 Waialae Ave Ste 208, Honolulu, HI 96816-5312 | 2011-09-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598370439 | Marina Nogues | Nurse Practitioner | 3901b Maunahilu Pl, Honolulu, HI 96816 | 2020-09-08 |
| 1184272007 | Gwen Mikasa | Speech-Language Pathologist | Office of Student Support Medicaid Reimbursement, 475 22nd Ave, Bldg 302, Room 101, Honolulu, HI 96816 | 2019-09-04 |
| 1467009290 | Abigail Hobbs | Occupational Therapist | 475 22nd Ave, Building 302, Rm. 101, Oss, Honolulu, HI 96816 | 2019-08-26 |
| 1588210587 | Mona Ann Hiyoto Akina | Speech-Language Pathologist | 475 2nd Ave., Room 127, Honolulu, HI 96816 | 2019-08-15 |
| 1356996599 | Karen Amanda Kama | Speech-Language Pathologist | Office of Student Support Services, 475 22nd Avenue Room 101, Honolulu, HI 96816 | 2019-08-05 |
| 1043864630 | Brittni Holt | Speech-Language Pathologist | 475 22nd Ave Building 302 Room 101, Honoluu, HI 96816 | 2019-07-31 |
| 1376197962 | Mallory Register | Speech-Language Pathologist | 475 22nd Avenue, Building 302, Room 101, Honolulu, HI 96816 | 2019-07-31 |
| 1588144935 | Mihoko Yacavone | Dietitian, Registered | 833 15th Ave, Honolulu, HI 96816 | 2018-08-15 |
| 1760976013 | Orthopaedic Specialists Hawaii LLC | Orthopaedic Surgery | 4348 Waialae Ave, Suite 479, Honolulu, HI 96816 | 2018-06-20 |
| 1790207389 | Richard Todd Robbins Jr. | Behavior Technician | 200 N. Vineyard Blvd. Suite A-600, Honolulu, HI 96816 | 2017-07-14 |
| Find all providers in zip 96816 | ||||
| Taxonomy Code | 261QM0855X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adolescent and Children Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932583978 | Rong Rong Enterprise L.L.C. | Clinic/Center | 377 Keahole Street, E211-d, Honolulu, HI 96825-0868 | 2015-07-18 |
| 1427510858 | Okupu LLC | Clinic/Center | 1221 Kapiolani Blvd Ste 248, Honolulu, HI 96814-3506 | 2019-04-04 |
| 1245758549 | Josephine P. Horita, D.o. LLC | Clinic/Center | 4211 Waialae Ave Ste 208, Honolulu, HI 96816-5312 | 2017-09-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043859200 | Ka Hoku Kai Counseling Center, LLC | Clinic/Center | 166 Kamehameha Ave Ste 1, Hilo, HI 96720-2857 | 2020-01-05 |
| 1184139156 | Rising Behavioral Health Consulting, LLC | Clinic/Center | 41-038 Wailea St Ste C, Waimanalo, HI 96795-1671 | 2017-12-12 |
| 1043745532 | Elemental Guidance LLC | Clinic/Center | 260 Kamehameha Ave, Hilo, HI 96720-2859 | 2017-04-22 |
| 1841650082 | Big Island Teen Counseling Center LLC | Clinic/Center | 224 Kamehameha Ave, Suite 206, Hilo, HI 96720-2860 | 2016-03-01 |
| 1649464355 | Bearden Psychological Services LLC | Clinic/Center | 101 Aupuni St, Suite 1014 A-2, Hilo, HI 96720-4246 | 2007-09-06 |
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| 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.