Provider Demographics
NPI:1619200797
Name:ALOHA WELLNESS CORPORATION
Entity Type:Organization
Organization Name:ALOHA WELLNESS CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, CEO
Authorized Official - Prefix:
Authorized Official - First Name:DESTINI
Authorized Official - Middle Name:Z
Authorized Official - Last Name:ADAMZ
Authorized Official - Suffix:
Authorized Official - Credentials:LMT
Authorized Official - Phone:706-896-3300
Mailing Address - Street 1:3243 HUMMINGBIRD LN
Mailing Address - Street 2:
Mailing Address - City:HIAWASSEE
Mailing Address - State:GA
Mailing Address - Zip Code:30546-1537
Mailing Address - Country:US
Mailing Address - Phone:706-896-3300
Mailing Address - Fax:706-896-1050
Practice Address - Street 1:4933 AUBURN AVE
Practice Address - Street 2:207-C
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-2631
Practice Address - Country:US
Practice Address - Phone:301-493-5400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-08
Last Update Date:2011-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU00160171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty