Provider Demographics
NPI:1295324135
Name:OHANA COMMUNITY SERVICES
Entity type:Organization
Organization Name:OHANA COMMUNITY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANSON
Authorized Official - Middle Name:
Authorized Official - Last Name:SERVICE
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:360-909-5762
Mailing Address - Street 1:717 NE 61ST ST STE 202
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98665-8756
Mailing Address - Country:US
Mailing Address - Phone:360-718-6548
Mailing Address - Fax:360-718-6554
Practice Address - Street 1:351 THREE RIVERS DR STE 166
Practice Address - Street 2:
Practice Address - City:KELSO
Practice Address - State:WA
Practice Address - Zip Code:98626-3125
Practice Address - Country:US
Practice Address - Phone:360-909-5762
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-14
Last Update Date:2021-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)