Provider Demographics
NPI:1629758164
Name:KANOELANI HOLOMALIA BEHAVIOR ANALYSIS LLC
Entity Type:Organization
Organization Name:KANOELANI HOLOMALIA BEHAVIOR ANALYSIS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KANOELANI
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLOMALIA
Authorized Official - Suffix:
Authorized Official - Credentials:LBA
Authorized Official - Phone:808-348-9126
Mailing Address - Street 1:1225 14TH AVE
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96816-3868
Mailing Address - Country:US
Mailing Address - Phone:808-348-9126
Mailing Address - Fax:
Practice Address - Street 1:1225 14TH AVE
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96816-3868
Practice Address - Country:US
Practice Address - Phone:808-348-9126
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-19
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty