Provider Demographics
NPI:1104173764
Name:HAWAII WHOLE PERSON HEALING COLLECTIVE, LLC
Entity type:Organization
Organization Name:HAWAII WHOLE PERSON HEALING COLLECTIVE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:S
Authorized Official - Last Name:LAWINSKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-936-1156
Mailing Address - Street 1:PO BOX 11349
Mailing Address - Street 2:
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96721-6349
Mailing Address - Country:US
Mailing Address - Phone:808-936-1156
Mailing Address - Fax:808-965-0323
Practice Address - Street 1:15-3039 PAHOA VILLAGE RD
Practice Address - Street 2:
Practice Address - City:PAHOA
Practice Address - State:HI
Practice Address - Zip Code:96778-9677
Practice Address - Country:US
Practice Address - Phone:808-936-1156
Practice Address - Fax:808-965-0323
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HAWAII WHOLE PERSON HEALING COLLECTIVE, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-08-13
Last Update Date:2019-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site