Provider Demographics
NPI:1548003858
Name:HAWAII BEHAVIORAL HEALTH SERVICES
Entity type:Organization
Organization Name:HAWAII BEHAVIORAL HEALTH SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:WILTON
Authorized Official - Middle Name:
Authorized Official - Last Name:MADISON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:808-621-8341
Mailing Address - Street 1:95-390 KUAHELANI AVE STE 3AC
Mailing Address - Street 2:
Mailing Address - City:MILILANI
Mailing Address - State:HI
Mailing Address - Zip Code:96789-1190
Mailing Address - Country:US
Mailing Address - Phone:808-366-8075
Mailing Address - Fax:
Practice Address - Street 1:70 S KAMEHAMEHA HWY
Practice Address - Street 2:
Practice Address - City:WAHIAWA
Practice Address - State:HI
Practice Address - Zip Code:96786-1856
Practice Address - Country:US
Practice Address - Phone:808-621-8341
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-14
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No251B00000XAgenciesCase Management
No324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility