Provider Demographics
NPI:1043760077
Name:OHANA WELLNESS MAUI, LLC
Entity Type:Organization
Organization Name:OHANA WELLNESS MAUI, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FAMILY THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:YVONNE
Authorized Official - Middle Name:
Authorized Official - Last Name:MANUPUNA
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:808-281-1901
Mailing Address - Street 1:PO BOX 1710
Mailing Address - Street 2:
Mailing Address - City:KAHULUI
Mailing Address - State:HI
Mailing Address - Zip Code:96733-1710
Mailing Address - Country:US
Mailing Address - Phone:808-281-1902
Mailing Address - Fax:
Practice Address - Street 1:135 S WAKEA AVE
Practice Address - Street 2:SUITE 105
Practice Address - City:KAHULUI
Practice Address - State:HI
Practice Address - Zip Code:96732-1385
Practice Address - Country:US
Practice Address - Phone:808-281-1902
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-14
Last Update Date:2016-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI493106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty