Provider Demographics
NPI:1922616549
Name:CHILD AND FAMILY SERVICE
Entity Type:Organization
Organization Name:CHILD AND FAMILY SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:P
Authorized Official - Last Name:ALAMODIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-476-3314
Mailing Address - Street 1:95-1091 AINAMAKUA DR
Mailing Address - Street 2:
Mailing Address - City:MILILANI
Mailing Address - State:HI
Mailing Address - Zip Code:96789-4252
Mailing Address - Country:US
Mailing Address - Phone:808-476-3314
Mailing Address - Fax:
Practice Address - Street 1:95-1091 AINAMAKUA DR
Practice Address - Street 2:
Practice Address - City:MILILANI
Practice Address - State:HI
Practice Address - Zip Code:96789-4252
Practice Address - Country:US
Practice Address - Phone:808-476-3314
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHILD AND FAMILY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-07-20
Last Update Date:2020-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health