Provider Demographics
NPI:1922427129
Name:POAILANI, INC
Entity Type:Organization
Organization Name:POAILANI, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ED
Authorized Official - Prefix:
Authorized Official - First Name:ABBY
Authorized Official - Middle Name:
Authorized Official - Last Name:PAREDES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-263-3500
Mailing Address - Street 1:970 N KALAHEO AVE
Mailing Address - Street 2:STE A102
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-1866
Mailing Address - Country:US
Mailing Address - Phone:808-263-3500
Mailing Address - Fax:
Practice Address - Street 1:553 KAWAINUI ST
Practice Address - Street 2:
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-2408
Practice Address - Country:US
Practice Address - Phone:808-263-3500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-15
Last Update Date:2014-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness