Provider Demographics
NPI:1467889295
Name:KAUAI COMMUNITY COLLEGE
Entity Type:Organization
Organization Name:KAUAI COMMUNITY COLLEGE
Other - Org Name:CAMPUS WELLNESS CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:CHANCELLOR
Authorized Official - Prefix:
Authorized Official - First Name:HELEN
Authorized Official - Middle Name:
Authorized Official - Last Name:COX
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:808-245-8210
Mailing Address - Street 1:3-1901 KAUMUALII HWY
Mailing Address - Street 2:
Mailing Address - City:LIHUE
Mailing Address - State:HI
Mailing Address - Zip Code:96766-9500
Mailing Address - Country:US
Mailing Address - Phone:808-245-8307
Mailing Address - Fax:
Practice Address - Street 1:3-1901 KAUMUALII HWY
Practice Address - Street 2:
Practice Address - City:LIHUE
Practice Address - State:HI
Practice Address - Zip Code:96766-9500
Practice Address - Country:US
Practice Address - Phone:808-245-8307
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-11
Last Update Date:2013-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center