Provider Demographics
NPI:1245440197
Name:MAUI ECONOMIC OPPORTUNITY, INC.
Entity type:Organization
Organization Name:MAUI ECONOMIC OPPORTUNITY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:SANANDA
Authorized Official - Middle Name:K
Authorized Official - Last Name:BAZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-249-2990
Mailing Address - Street 1:PO BOX 2122
Mailing Address - Street 2:
Mailing Address - City:KAHULUI
Mailing Address - State:HI
Mailing Address - Zip Code:96733-2122
Mailing Address - Country:US
Mailing Address - Phone:808-249-2990
Mailing Address - Fax:808-249-2991
Practice Address - Street 1:189 W KAAHUMANU AVE
Practice Address - Street 2:
Practice Address - City:KAHULUI
Practice Address - State:HI
Practice Address - Zip Code:96732-1606
Practice Address - Country:US
Practice Address - Phone:808-877-7651
Practice Address - Fax:808-871-2171
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI081300-01Medicaid