Provider Demographics
NPI:1528453669
Name:POWER ON COACHING, INC.
Entity type:Organization
Organization Name:POWER ON COACHING, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:C.E.O./PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:DONOVAN
Authorized Official - Last Name:SCHROEDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-702-2085
Mailing Address - Street 1:P.O. BOX 165
Mailing Address - Street 2:
Mailing Address - City:HAKALAU
Mailing Address - State:HI
Mailing Address - Zip Code:96710
Mailing Address - Country:US
Mailing Address - Phone:800-775-0200
Mailing Address - Fax:808-775-9007
Practice Address - Street 1:31-631 OLD MAMALAHOA HIGHWAY
Practice Address - Street 2:
Practice Address - City:HAKALAU
Practice Address - State:HI
Practice Address - Zip Code:96710
Practice Address - Country:US
Practice Address - Phone:800-775-0200
Practice Address - Fax:808-775-9007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-06
Last Update Date:2024-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI101-STF324500000X
320800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
No324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility