Provider Demographics
NPI:1245834779
Name:BLESSED HANDS IV HYDRATION & WELLNESS LLC
Entity type:Organization
Organization Name:BLESSED HANDS IV HYDRATION & WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:LUCKY
Authorized Official - Middle Name:K
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:AGPC, DNP-C
Authorized Official - Phone:808-378-2400
Mailing Address - Street 1:3501 RICE ST STE 2020
Mailing Address - Street 2:
Mailing Address - City:LIHUE
Mailing Address - State:HI
Mailing Address - Zip Code:96766-1757
Mailing Address - Country:US
Mailing Address - Phone:808-378-2400
Mailing Address - Fax:866-783-9834
Practice Address - Street 1:3501 RICE ST STE 2022
Practice Address - Street 2:
Practice Address - City:LIHUE
Practice Address - State:HI
Practice Address - Zip Code:96766-1757
Practice Address - Country:US
Practice Address - Phone:808-755-5056
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-25
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Multi-Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center