Provider Demographics
NPI:1013190909
Name:COMMUNITY MENTAL HEALTH CENTER CLUBHOUSE-DIAMOND HEAD
Entity Type:Organization
Organization Name:COMMUNITY MENTAL HEALTH CENTER CLUBHOUSE-DIAMOND HEAD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCIAL RESOURCE SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:RAQUEL
Authorized Official - Middle Name:B
Authorized Official - Last Name:NAKAHARA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-586-8276
Mailing Address - Street 1:1250 PUNCHBOWL ST
Mailing Address - Street 2:RM 256
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-2416
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3627 KILAUEA AVE
Practice Address - Street 2:BLDG. 410
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96816
Practice Address - Country:US
Practice Address - Phone:808-733-9188
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DEPARTMENT OF HEALTH, ADULT MENTAL HEALTH DIVISION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-12-13
Last Update Date:2007-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health