Provider Demographics
NPI:1215376793
Name:A HONU AUTISM CENTER
Entity Type:Organization
Organization Name:A HONU AUTISM CENTER
Other - Org Name:MALAMA PONO AUTISM CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:K
Authorized Official - Last Name:DUNCAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-465-5003
Mailing Address - Street 1:100 KAHELU AVE
Mailing Address - Street 2:SUITE 102A
Mailing Address - City:MILILANI
Mailing Address - State:HI
Mailing Address - Zip Code:96789-3913
Mailing Address - Country:US
Mailing Address - Phone:719-465-5003
Mailing Address - Fax:719-465-5101
Practice Address - Street 1:100 KAHELU AVE
Practice Address - Street 2:SUITE 102A
Practice Address - City:MILILANI
Practice Address - State:HI
Practice Address - Zip Code:96789-3913
Practice Address - Country:US
Practice Address - Phone:719-465-5003
Practice Address - Fax:719-465-5101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-18
Last Update Date:2013-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty