Provider Demographics
NPI:1659586725
Name:LDS FAMILY SERVICES
Entity Type:Organization
Organization Name:LDS FAMILY SERVICES
Other - Org Name:LDS FAMILY SERVICES HAWAII AGENCY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AGENCY DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ALIFELETI
Authorized Official - Middle Name:
Authorized Official - Last Name:MALUPO
Authorized Official - Suffix:
Authorized Official - Credentials:MED
Authorized Official - Phone:808-945-3690
Mailing Address - Street 1:1500 S BERETANIA ST
Mailing Address - Street 2:SUITE 402
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96826-1932
Mailing Address - Country:US
Mailing Address - Phone:808-945-3690
Mailing Address - Fax:808-945-2811
Practice Address - Street 1:1500 S BERETANIA ST
Practice Address - Street 2:SUITE 402
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96826-1932
Practice Address - Country:US
Practice Address - Phone:808-945-3690
Practice Address - Fax:808-945-2811
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LDS FAMILY SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-05-11
Last Update Date:2008-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI870489254261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)