Provider Demographics
NPI:1508922543
Name:BEHAVIORAL & PSYCHATRIC SERVICES OF HAWAII INC
Entity Type:Organization
Organization Name:BEHAVIORAL & PSYCHATRIC SERVICES OF HAWAII INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT SECRETARY TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:DON
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:MD MPH
Authorized Official - Phone:808-935-4444
Mailing Address - Street 1:135 PUUHONU WAY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720
Mailing Address - Country:US
Mailing Address - Phone:808-935-9699
Mailing Address - Fax:808-935-7720
Practice Address - Street 1:135 PUUHONU WAY
Practice Address - Street 2:SUITE 200
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720
Practice Address - Country:US
Practice Address - Phone:808-935-9699
Practice Address - Fax:808-935-7720
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD52672084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
0000BDXTPMedicare ID - Type Unspecified
D36364Medicare UPIN