Provider Demographics
NPI:1124145149
Name:KIDS BEHAVIORAL HEALTH OF HAWAII, INC.
Entity type:Organization
Organization Name:KIDS BEHAVIORAL HEALTH OF HAWAII, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PATIENT FINANCIAL SERVI
Authorized Official - Prefix:
Authorized Official - First Name:PAT
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-777-2265
Mailing Address - Street 1:11175 CICERO DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30022-1148
Mailing Address - Country:US
Mailing Address - Phone:770-754-5232
Mailing Address - Fax:770-776-5321
Practice Address - Street 1:440 KAPIOLANI ST
Practice Address - Street 2:
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-3937
Practice Address - Country:US
Practice Address - Phone:808-961-6635
Practice Address - Fax:808-961-6925
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes322D00000XResidential Treatment FacilitiesResidential Treatment Facility, Emotionally Disturbed Children