Provider Demographics
NPI:1598902744
Name:NARCONON HAWAII
Entity Type:Organization
Organization Name:NARCONON HAWAII
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF LEGAL AFFAIRS
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:L
Authorized Official - Last Name:FARNSWORTH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-871-8644
Mailing Address - Street 1:PO BOX 75246
Mailing Address - Street 2:
Mailing Address - City:KAPOLEI
Mailing Address - State:HI
Mailing Address - Zip Code:96707-0246
Mailing Address - Country:US
Mailing Address - Phone:808-550-0005
Mailing Address - Fax:
Practice Address - Street 1:90-1011 LEXINGTON AVENUE
Practice Address - Street 2:
Practice Address - City:KAPOLEI
Practice Address - State:HI
Practice Address - Zip Code:76707
Practice Address - Country:US
Practice Address - Phone:808-550-0005
Practice Address - Fax:808-550-0009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-09
Last Update Date:2009-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility