Provider Demographics
NPI:1871660902
Name:SALVATION ARMY ADDICTION TREATMENT SERVICES
Entity Type:Organization
Organization Name:SALVATION ARMY ADDICTION TREATMENT SERVICES
Other - Org Name:SALVATION ARMY ATS
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:H
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-595-6371
Mailing Address - Street 1:3624 WAOKANAKA ST
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817-5224
Mailing Address - Country:US
Mailing Address - Phone:808-595-6371
Mailing Address - Fax:808-595-8250
Practice Address - Street 1:3624 WAOKANAKA ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-5224
Practice Address - Country:US
Practice Address - Phone:808-595-6371
Practice Address - Fax:808-595-8250
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIOHCA#13-STF324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility