Provider Demographics
NPI:1417466566
Name:RANDALL PAGLINAWAN LLC
Entity Type:Organization
Organization Name:RANDALL PAGLINAWAN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RANDALL
Authorized Official - Middle Name:D
Authorized Official - Last Name:PAGLINAWAN
Authorized Official - Suffix:
Authorized Official - Credentials:MHC
Authorized Official - Phone:808-263-1923
Mailing Address - Street 1:40 AULIKE ST STE 217
Mailing Address - Street 2:
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-2753
Mailing Address - Country:US
Mailing Address - Phone:808-263-1923
Mailing Address - Fax:808-263-1920
Practice Address - Street 1:40 AULIKE ST STE 217
Practice Address - Street 2:
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-2753
Practice Address - Country:US
Practice Address - Phone:808-263-1923
Practice Address - Fax:808-263-1920
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI415251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health