Provider Demographics
NPI:1962041244
Name:PAG-ASA IN PARADISE LLC
Entity Type:Organization
Organization Name:PAG-ASA IN PARADISE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL SOCIAL WORKER
Authorized Official - Prefix:MS
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:
Authorized Official - Last Name:TORIGOE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:808-990-1482
Mailing Address - Street 1:366 W PUAINAKO ST
Mailing Address - Street 2:
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-2745
Mailing Address - Country:US
Mailing Address - Phone:808-990-1482
Mailing Address - Fax:855-674-1817
Practice Address - Street 1:366 W PUAINAKO ST
Practice Address - Street 2:
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-2745
Practice Address - Country:US
Practice Address - Phone:808-990-1482
Practice Address - Fax:855-674-1817
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-03
Last Update Date:2023-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty