Provider Demographics
NPI:1578615514
Name:BIG ISLAND SUBSTANCE ABUSE COUNCIL
Entity Type:Organization
Organization Name:BIG ISLAND SUBSTANCE ABUSE COUNCIL
Other - Org Name:BISAC
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:HANNAH
Authorized Official - Middle Name:K
Authorized Official - Last Name:PRESTON-PITA
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:808-969-9994
Mailing Address - Street 1:16-179 MELEKAHIWA STREET
Mailing Address - Street 2:
Mailing Address - City:KEA'AU
Mailing Address - State:HI
Mailing Address - Zip Code:96749
Mailing Address - Country:US
Mailing Address - Phone:808-969-9994
Mailing Address - Fax:808-969-7570
Practice Address - Street 1:297 WAIANUENUE AVENUE
Practice Address - Street 2:
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-2438
Practice Address - Country:US
Practice Address - Phone:808-935-4927
Practice Address - Fax:808-934-8067
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-18
Last Update Date:2013-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI251S00000X, 261QM0850X, 261QM0855X, 261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIJ000920-7OtherHILO COMMERCIAL #
HIL000920-3OtherE. HI-ADOL. COMMERCIAL #
HIB000920-5OtherKONA COMMERCIAL PROV. #
HI00J000920-7OtherHILO QUEST PROVIDER #
HI3747OtherALOHACARE PROVIDER #
HI00P000920-4OtherWAIMEA QUEST PROVIDER #
HIP000920-4OtherWAIMEA COMMERCIAL PROV. #
HI00B000920-5OtherKONA QUEST PROVIDER #
HIE000920-8OtherW. HI-ADOL COMMECIAL #
HI00E000920-8OtherW. HI-ADOL QUEST PROV #
HI00L000920-3OtherE. HI-ADOL. QUEST #
HIF0009206OtherKAPOLEI QUEST PROVIDER #
HIG0009204OtherWAIANAE QUEST PROVIDER #
HIBB909Medicare UPIN