Provider Demographics
NPI:1851703607
Name:ELIZABETH KEOLANI TAITANO, PH.D., LLC
Entity Type:Organization
Organization Name:ELIZABETH KEOLANI TAITANO, PH.D., LLC
Other - Org Name:WINDWARD BEHAVIORAL HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:KEOLANI
Authorized Official - Last Name:TAITANO
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:808-341-4328
Mailing Address - Street 1:PO BOX 884
Mailing Address - Street 2:
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-0884
Mailing Address - Country:US
Mailing Address - Phone:808-341-4328
Mailing Address - Fax:877-348-8227
Practice Address - Street 1:40 AULIKE ST
Practice Address - Street 2:SUITE 411
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-2758
Practice Address - Country:US
Practice Address - Phone:808-341-4328
Practice Address - Fax:877-348-8227
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-28
Last Update Date:2017-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty