Provider Demographics
NPI:1306685920
Name:JOY GALLINA, LLC
Entity type:Organization
Organization Name:JOY GALLINA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JOY
Authorized Official - Middle Name:
Authorized Official - Last Name:GALLINA
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:808-385-6382
Mailing Address - Street 1:220 POHAKULANI ST
Mailing Address - Street 2:
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-3160
Mailing Address - Country:US
Mailing Address - Phone:808-385-6382
Mailing Address - Fax:
Practice Address - Street 1:220 POHAKULANI ST
Practice Address - Street 2:
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-3160
Practice Address - Country:US
Practice Address - Phone:808-385-6382
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JOY GALLINA, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-05-22
Last Update Date:2024-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)