Provider Demographics
NPI:1457642076
Name:ALOHA HOUSE
Entity Type:Organization
Organization Name:ALOHA HOUSE
Other - Org Name:CRISIS MOBILE OUTREACH-CAMHD
Other - Org Type:Other Name
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DARYL
Authorized Official - Middle Name:
Authorized Official - Last Name:SELMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-579-8414
Mailing Address - Street 1:200 IKE DR
Mailing Address - Street 2:
Mailing Address - City:MAKAWAO
Mailing Address - State:HI
Mailing Address - Zip Code:96768-9718
Mailing Address - Country:US
Mailing Address - Phone:808-579-8414
Mailing Address - Fax:808-579-8426
Practice Address - Street 1:200 IKE DR
Practice Address - Street 2:
Practice Address - City:MAKAWAO
Practice Address - State:HI
Practice Address - Zip Code:96768-9718
Practice Address - Country:US
Practice Address - Phone:808-579-8414
Practice Address - Fax:808-579-8426
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALOHA HOUSE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-04-29
Last Update Date:2014-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251S00000X
HI28STF324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility