Provider Demographics
NPI:1023797388
Name:INTEGRATIVE THERAPEUTICS, LLC
Entity type:Organization
Organization Name:INTEGRATIVE THERAPEUTICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KUULEIKUPONOOKEALOHA
Authorized Official - Middle Name:
Authorized Official - Last Name:NAAHIELUA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-867-6477
Mailing Address - Street 1:1050 QUEEN ST STE 100
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-4130
Mailing Address - Country:US
Mailing Address - Phone:808-867-6477
Mailing Address - Fax:
Practice Address - Street 1:98-1247 KAAHUMANU ST STE 221
Practice Address - Street 2:
Practice Address - City:AIEA
Practice Address - State:HI
Practice Address - Zip Code:96701-5310
Practice Address - Country:US
Practice Address - Phone:808-867-6477
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-14
Last Update Date:2023-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Multi-Specialty
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontologyGroup - Multi-Specialty