Provider Demographics
NPI:1962077560
Name:CHAPLAIN MINISTRIES OF MAUI
Entity type:Organization
Organization Name:CHAPLAIN MINISTRIES OF MAUI
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:THRESIA
Authorized Official - Middle Name:
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:813-699-9138
Mailing Address - Street 1:PO BOX 330415
Mailing Address - Street 2:
Mailing Address - City:KAHULUI
Mailing Address - State:HI
Mailing Address - Zip Code:96733-0415
Mailing Address - Country:US
Mailing Address - Phone:813-699-9138
Mailing Address - Fax:877-770-2109
Practice Address - Street 1:1942 MAIN ST # 106A
Practice Address - Street 2:
Practice Address - City:WAILUKU
Practice Address - State:HI
Practice Address - Zip Code:96793-1750
Practice Address - Country:US
Practice Address - Phone:808-897-0527
Practice Address - Fax:877-770-2109
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-25
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty