Provider Demographics
NPI:1578189247
Name:HAWAII HOLISTIC CARE
Entity Type:Organization
Organization Name:HAWAII HOLISTIC CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELENA
Authorized Official - Middle Name:YURIEVNA
Authorized Official - Last Name:KOZMIDI
Authorized Official - Suffix:
Authorized Official - Credentials:LAC, LMT
Authorized Official - Phone:808-769-2263
Mailing Address - Street 1:PO BOX 383882
Mailing Address - Street 2:
Mailing Address - City:WAIKOLOA
Mailing Address - State:HI
Mailing Address - Zip Code:96738-3882
Mailing Address - Country:US
Mailing Address - Phone:808-769-2263
Mailing Address - Fax:
Practice Address - Street 1:64-957 MAMALAHOA HWY
Practice Address - Street 2:
Practice Address - City:KAMUELA
Practice Address - State:HI
Practice Address - Zip Code:96743-8415
Practice Address - Country:US
Practice Address - Phone:808-769-2263
Practice Address - Fax:808-431-3092
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-18
Last Update Date:2020-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty