Provider Demographics
NPI:1821506965
Name:HUKILANI LLC
Entity Type:Organization
Organization Name:HUKILANI LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:JEANNIE
Authorized Official - Middle Name:M
Authorized Official - Last Name:HUGHES
Authorized Official - Suffix:
Authorized Official - Credentials:LIMHP
Authorized Official - Phone:808-754-6720
Mailing Address - Street 1:4141 RIVERS EDGE PKWY APT 306
Mailing Address - Street 2:
Mailing Address - City:COUNCIL BLUFFS
Mailing Address - State:IA
Mailing Address - Zip Code:51501-5203
Mailing Address - Country:US
Mailing Address - Phone:808-754-6720
Mailing Address - Fax:531-999-4938
Practice Address - Street 1:1299 FARNAM ST STE 300
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68102-1857
Practice Address - Country:US
Practice Address - Phone:808-754-6720
Practice Address - Fax:531-999-4938
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-10
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE4803261QM0801X
IA089415261QM0801X
261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)