Provider Demographics
NPI:1326651753
Name:SLEEP CENTER HAWAII LLC
Entity Type:Organization
Organization Name:SLEEP CENTER HAWAII LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DIVINA
Authorized Official - Middle Name:
Authorized Official - Last Name:MESA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-456-7378
Mailing Address - Street 1:56 KAMEHAMEHA AVE
Mailing Address - Street 2:
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-2831
Mailing Address - Country:US
Mailing Address - Phone:808-969-7378
Mailing Address - Fax:808-969-8189
Practice Address - Street 1:56 KAMEHAMEHA AVE
Practice Address - Street 2:
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-2831
Practice Address - Country:US
Practice Address - Phone:808-969-7378
Practice Address - Fax:808-969-8189
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SLEEP CENTER HAWAII LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-08-25
Last Update Date:2020-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep MedicineGroup - Single Specialty