BOBBY BENSON CENTER (NPI# 1962659540) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962659540 |
| Entity Type | Organization |
| Organization Name | BOBBY BENSON CENTER |
| Practice Address |
56-660 Kamehameha Hwy Kahuku HI 96731-2210 |
| Mailing Address |
56-660 Kamehameha Highway Kahuku HI 96731 |
| Practice Telephone | 8082937555 |
| Practice Fax Number | 8082937196 |
| Mailing Telephone | 8082937555 |
| Mailing Fax Number | 8082937196 |
| Enumeration Date | 2008-08-26 |
| Last Update Date | 2008-08-26 |
| Authorized Official Name | MR. JEFF WAGNER (DIRECTOR) |
| Authorized Official Telephone | 8082937555 |
| Authorized Official Credential | MFT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | 320800000X | HI | Residential Treatment Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306904461 | Bobby Benson Center | Substance Abuse Rehabilitation Facility | 56-660 Kamehameha Hwy, Kahuku, HI 96731-2210 | 2006-12-04 |
| Street Address |
56-660 KAMEHAMEHA HWY |
| City | KAHUKU |
| State | HI |
| Zip Code | 96731-2210 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306904461 | Bobby Benson Center | Substance Abuse Rehabilitation Facility | 56-660 Kamehameha Hwy, Kahuku, HI 96731-2210 | 2006-12-04 |
| 1679171078 | Tiffany Kristine Gougeon | Registered Nurse | 56-660 Kamehameha Hwy, Kahuku, HI 96731-2210 | 2020-10-16 |
| 1033717665 | Luseane Latu | Counselor | 56-660 Kamehameha Hwy, Kahuku, HI 96731-2210 | 2020-10-15 |
| 1114544145 | Melita Maramanisiga Matanatabu | Counselor | 56-660 Kamehameha Hwy, Kahuku, HI 96731-2210 | 2020-06-25 |
| 1417573478 | Soli K.m. Afalava | Counselor | 56-660 Kamehameha Hwy, Kahuku, HI 96731-2210 | 2020-06-24 |
| 1942826391 | Josevata Dredre Damuni | Counselor | 56-660 Kamehameha Hwy, Kahuku, HI 96731-2210 | 2020-06-22 |
| 1013533389 | Sione Ford Naeata | Counselor | 56-660 Kamehameha Hwy, Kahuku, HI 96731-2210 | 2020-06-22 |
| 1710503263 | Isabella Dearaujo | Counselor | 56-660 Kamehameha Hwy, Kahuku, HI 96731-2210 | 2020-06-21 |
| 1194341990 | John Labarre Moleni | Counselor | 56-660 Kamehameha Hwy, Kahuku, HI 96731-2210 | 2020-06-18 |
| 1316563265 | Kolokesa Piutau | Counselor | 56-660 Kamehameha Hwy, Kahuku, HI 96731-2210 | 2020-06-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174149405 | Teniiti Taie Burennatu | Counselor | 55-660 Kamehameha Hwy, Kahuku, HI 96731 | 2020-06-23 |
| 1568909109 | Maia Miller | Specialist/Technologist | 46-590 Kamehameha Hwy, Kahuku High School, Kahuku, HI 96731 | 2017-01-20 |
| 1063766079 | Ko'olauloa Health Center | Clinic/Center | 56-490 Kamehameha Hwy R-building Rm 104, Kahuku, HI 96731 | 2012-10-30 |
| 1295097830 | Kerry Saitia Moea'i | Social Worker | 56-395 Huehu St., Kahuku, HI 96731 | 2012-06-11 |
| 1114194073 | Jason Hughes | Internal Medicine | 56-117 Pualalea Street, Kahuku, HI 96731 | 2008-05-09 |
| 1942341318 | Kaiser Foundation Health Plan Inc | Pharmacy | 56 700 Kamehameha Highway, Kahuku, HI 96731 | 2007-02-09 |
| 1659438281 | Carol Francine Green | Social Worker | 56 565 Kamehameha Hwy, Kahuku, HI 96731 | 2007-01-02 |
| 1578508602 | Douglas A Sutherland | Pediatrics | 56 119 Pualalea St, Kahuku, HI 96731 | 2006-06-20 |
| 1528026952 | Ko'olauloa Health Center | Clinic/Center | 56-119 Pualalea St., Kahuku, HI 96731 | 2006-05-03 |
| 1144683012 | Tara Reed | Internal Medicine | 56-119 Pualalea St, Kahuku, HI 96731 | 2016-03-30 |
| Find all providers in zip 96731 | ||||
| Taxonomy Code | 320800000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment Facility, Mental Illness |
| A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386270551 | Stephanie Makino-kahuli | Community Based Residential Treatment Facility, Mental Illness | 1786 Kinoole St, Hilo, HI 96720-5245 | 2020-03-19 |
| 1073969036 | Armen Armaghanyan | Community Based Residential Treatment Facility, Mental Illness | 896 Kumukoa St, Hilo, HI 96720-4028 | 2016-05-09 |
| 1922427129 | Poailani, Inc | Community Based Residential Treatment Facility, Mental Illness | 553 Kawainui St, Kailua, HI 96734-2408 | 2014-04-15 |
| 1194140251 | Care Hawaii, Inc. | Community Based Residential Treatment Facility, Mental Illness | 1668 Hoohulu St, Pearl City, HI 96782-1805 | 2014-02-26 |
| 1467877522 | Care Hawaii, Inc. | Community Based Residential Treatment Facility, Mental Illness | 98-839 Kaamilo St, Aiea, HI 96701-3446 | 2014-02-26 |
| 1932524568 | Poilani, Inc | Community Based Residential Treatment Facility, Mental Illness | 74 Kihapai St, Kailua, HI 96734-2612 | 2014-02-18 |
| 1144659020 | Nova Luna, Inc. | Community Based Residential Treatment Facility, Mental Illness | 470 Lilihua Pl, Wailuku, HI 96793-1313 | 2013-11-01 |
| 1518225531 | Small Kine Polynesian | Community Based Residential Treatment Facility, Mental Illness | 55-025 Lanihuli St, Laie, HI 96762-1225 | 2012-04-27 |
| 1598057275 | Po'ailani, Inc. | Community Based Residential Treatment Facility, Mental Illness | 970 N Kalaheo Ave Ste A102, Kailua, HI 96734-1868 | 2011-05-12 |
| 1871797381 | Marimed Foundation for Island Health Care Training | Community Based Residential Treatment Facility, Mental Illness | 45-021 Likeke Pl, Kaneohe, HI 96744-2426 | 2007-06-11 |
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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.