Provider Demographics
NPI:1477151249
Name:THE OHANA RETREAT LLC
Entity Type:Organization
Organization Name:THE OHANA RETREAT LLC
Other - Org Name:THE OHANA ADDICTION TREATMENT CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ELLIOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:877-664-2622
Mailing Address - Street 1:75-5915 WALUA RD
Mailing Address - Street 2:
Mailing Address - City:KAILUA KONA
Mailing Address - State:HI
Mailing Address - Zip Code:96740-1375
Mailing Address - Country:US
Mailing Address - Phone:877-664-2622
Mailing Address - Fax:
Practice Address - Street 1:73-4617 KALOKO HALIA PL
Practice Address - Street 2:
Practice Address - City:KAILUA KONA
Practice Address - State:HI
Practice Address - Zip Code:96740-8666
Practice Address - Country:US
Practice Address - Phone:877-664-2622
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-14
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No177F00000XOther Service ProvidersLodging
No251B00000XAgenciesCase Management
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder