Provider Demographics
NPI:1700415387
Name:KAIMANA INTEGRATIVE HEALTH INC.
Entity Type:Organization
Organization Name:KAIMANA INTEGRATIVE HEALTH INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:
Authorized Official - Last Name:BECKER-BRUNGARD
Authorized Official - Suffix:
Authorized Official - Credentials:ND, LAC
Authorized Official - Phone:808-300-2432
Mailing Address - Street 1:25-238 PUKANA LA ST
Mailing Address - Street 2:
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-1381
Mailing Address - Country:US
Mailing Address - Phone:808-300-2432
Mailing Address - Fax:
Practice Address - Street 1:192 KAPIOLANI ST
Practice Address - Street 2:
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-7825
Practice Address - Country:US
Practice Address - Phone:808-300-2432
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-05
Last Update Date:2022-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center