Provider Demographics
NPI:1346961703
Name:KULEANA HEALTH & WELLNESS LLC
Entity Type:Organization
Organization Name:KULEANA HEALTH & WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KEOHIKAI
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:LAIKUPU
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:808-634-7231
Mailing Address - Street 1:PO BOX 492412
Mailing Address - Street 2:
Mailing Address - City:KEAAU
Mailing Address - State:HI
Mailing Address - Zip Code:96749-2412
Mailing Address - Country:US
Mailing Address - Phone:808-634-7231
Mailing Address - Fax:
Practice Address - Street 1:15-1370 25TH AVE
Practice Address - Street 2:
Practice Address - City:KEAAU
Practice Address - State:HI
Practice Address - Zip Code:96749
Practice Address - Country:US
Practice Address - Phone:808-634-7231
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-06
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care