Provider Demographics
NPI:1619106713
Name:RECOVERY IN PARADISE, LLC
Entity Type:Organization
Organization Name:RECOVERY IN PARADISE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:KAAINOA
Authorized Official - Last Name:KANEAIAKALA
Authorized Official - Suffix:III
Authorized Official - Credentials:CSAC, MBA
Authorized Official - Phone:808-285-4520
Mailing Address - Street 1:PO BOX 2777
Mailing Address - Street 2:
Mailing Address - City:WAIANAE
Mailing Address - State:HI
Mailing Address - Zip Code:96792-8777
Mailing Address - Country:US
Mailing Address - Phone:808-285-4520
Mailing Address - Fax:
Practice Address - Street 1:87-107 KALEIWOHI ST
Practice Address - Street 2:
Practice Address - City:WAIANAE
Practice Address - State:HI
Practice Address - Zip Code:96792-3681
Practice Address - Country:US
Practice Address - Phone:808-285-4520
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-09
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health