Provider Demographics
NPI:1073674602
Name:LOKAHI TREATMENT CENTERS
Entity Type:Organization
Organization Name:LOKAHI TREATMENT CENTERS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMAL
Authorized Official - Middle Name:F
Authorized Official - Last Name:WASAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, CSAC
Authorized Official - Phone:808-883-0922
Mailing Address - Street 1:PO BOX 383401
Mailing Address - Street 2:
Mailing Address - City:WAIKOLOA
Mailing Address - State:HI
Mailing Address - Zip Code:96738-3401
Mailing Address - Country:US
Mailing Address - Phone:808-883-0922
Mailing Address - Fax:808-883-1022
Practice Address - Street 1:68-1845 WAIKOLOA ROAD
Practice Address - Street 2:WAIKOLOA HIGHLANDS SHOPPING CENTER SUITE 224B
Practice Address - City:WAIKOLOA
Practice Address - State:HI
Practice Address - Zip Code:96738
Practice Address - Country:US
Practice Address - Phone:808-883-0922
Practice Address - Fax:808-883-1022
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI1548210347OtherBISSET NPI
HI55787901Medicaid
HI56024401Medicaid
HI1427129196OtherWASAN NPI
HID44865Medicare UPIN
HI56822Medicare PIN
HI56024401Medicaid
HI56818Medicare PIN