Provider Demographics
NPI:1356864250
Name:PLAY THERAPY & COUNSELING CENTER OF HAWAII, LLC
Entity Type:Organization
Organization Name:PLAY THERAPY & COUNSELING CENTER OF HAWAII, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GINA
Authorized Official - Middle Name:HELM
Authorized Official - Last Name:EUSTAQUIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-261-0066
Mailing Address - Street 1:315 ULUNIU ST STE 207
Mailing Address - Street 2:
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-2523
Mailing Address - Country:US
Mailing Address - Phone:808-261-0066
Mailing Address - Fax:
Practice Address - Street 1:315 ULUNIU ST STE 207
Practice Address - Street 2:
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-2523
Practice Address - Country:US
Practice Address - Phone:808-261-0066
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-23
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty