Provider Demographics
NPI:1770183980
Name:PAKOLEA SUPPORT SERVICES
Entity Type:Organization
Organization Name:PAKOLEA SUPPORT SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMIN OF CLINICAL OP/CO FOUNDER
Authorized Official - Prefix:MS
Authorized Official - First Name:LA REINA
Authorized Official - Middle Name:M
Authorized Official - Last Name:KAMALANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-346-6690
Mailing Address - Street 1:4151 MOMI ST
Mailing Address - Street 2:
Mailing Address - City:KILAUEA
Mailing Address - State:HI
Mailing Address - Zip Code:96754-5312
Mailing Address - Country:US
Mailing Address - Phone:808-639-5896
Mailing Address - Fax:
Practice Address - Street 1:1895 HALEUKANA ST
Practice Address - Street 2:
Practice Address - City:LIHUE
Practice Address - State:HI
Practice Address - Zip Code:96766-9072
Practice Address - Country:US
Practice Address - Phone:808-346-6690
Practice Address - Fax:888-841-0904
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-27
Last Update Date:2022-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty