Provider Demographics
NPI:1508372285
Name:OHANA THERAPY HAWAII, LLC
Entity Type:Organization
Organization Name:OHANA THERAPY HAWAII, LLC
Other - Org Name:ELVIRA ELLAZAR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MARRIAGE AND FAMILY THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ELVIRA
Authorized Official - Middle Name:MARSHA
Authorized Official - Last Name:ELLAZAR
Authorized Official - Suffix:
Authorized Official - Credentials:MFT
Authorized Official - Phone:808-497-0816
Mailing Address - Street 1:PO BOX 6348
Mailing Address - Street 2:
Mailing Address - City:KANEOHE
Mailing Address - State:HI
Mailing Address - Zip Code:96744-9173
Mailing Address - Country:US
Mailing Address - Phone:808-551-8948
Mailing Address - Fax:
Practice Address - Street 1:99-128 AIEA HEIGHTS DR STE 301
Practice Address - Street 2:
Practice Address - City:AIEA
Practice Address - State:HI
Practice Address - Zip Code:96701-3933
Practice Address - Country:US
Practice Address - Phone:808-497-0816
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-18
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI487106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI=========Medicaid