Provider Demographics
NPI:1396173894
Name:V&D PSYCHIATRY, LLC
Entity type:Organization
Organization Name:V&D PSYCHIATRY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PROVIDER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:P
Authorized Official - Last Name:DUPREY
Authorized Official - Suffix:JR
Authorized Official - Credentials:APRN-RX, PMHNP-BC
Authorized Official - Phone:888-321-7760
Mailing Address - Street 1:4725 BOUGAINVILLE DR
Mailing Address - Street 2:#351
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96818-3179
Mailing Address - Country:US
Mailing Address - Phone:888-321-7760
Mailing Address - Fax:
Practice Address - Street 1:4725 BOUGAINVILLE DR
Practice Address - Street 2:#351
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96818-3179
Practice Address - Country:US
Practice Address - Phone:888-321-7760
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-17
Last Update Date:2013-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIW57111661-01261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)