Provider Demographics
NPI:1679643464
Name:ALOHA WELLNESS CENTER INC.
Entity Type:Organization
Organization Name:ALOHA WELLNESS CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALMA
Authorized Official - Middle Name:
Authorized Official - Last Name:BERSAMIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-484-9106
Mailing Address - Street 1:98-1247 KAAHUMANU ST
Mailing Address - Street 2:109B
Mailing Address - City:AIEA
Mailing Address - State:HI
Mailing Address - Zip Code:96701-5311
Mailing Address - Country:US
Mailing Address - Phone:808-484-9106
Mailing Address - Fax:
Practice Address - Street 1:98-1247 KAAHUMANU ST
Practice Address - Street 2:109B
Practice Address - City:AIEA
Practice Address - State:HI
Practice Address - Zip Code:96701-5311
Practice Address - Country:US
Practice Address - Phone:808-484-9106
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPT2010261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy