Provider Demographics
NPI:1942913876
Name:KAMAUNU BEHAVIORAL HEALTH SERVICES LLC
Entity Type:Organization
Organization Name:KAMAUNU BEHAVIORAL HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KOLLIN
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:KAMAUNU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-364-7926
Mailing Address - Street 1:91-1173 KAUIKI ST
Mailing Address - Street 2:
Mailing Address - City:EWA BEACH
Mailing Address - State:HI
Mailing Address - Zip Code:96706-2843
Mailing Address - Country:US
Mailing Address - Phone:808-364-7926
Mailing Address - Fax:
Practice Address - Street 1:3330 WYNN RD STE D
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89102-8238
Practice Address - Country:US
Practice Address - Phone:808-364-7926
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-05
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health