Provider Demographics
NPI:1720125032
Name:ALAKA'I NA KEIKI, INC.
Entity Type:Organization
Organization Name:ALAKA'I NA KEIKI, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:J
Authorized Official - Last Name:KRAVETZ
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:808-523-7771
Mailing Address - Street 1:1100 ALAKEA ST
Mailing Address - Street 2:UNIT 9
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-2833
Mailing Address - Country:US
Mailing Address - Phone:808-523-7771
Mailing Address - Fax:808-523-1997
Practice Address - Street 1:1100 ALAKEA ST
Practice Address - Street 2:UNIT 9
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-2833
Practice Address - Country:US
Practice Address - Phone:808-523-7771
Practice Address - Fax:808-523-1997
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2008-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPSY368103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI02439706Medicaid
02656406OtherALOHACARE WAIANAE
HI02439704Medicaid
HI02439703Medicaid
02656405OtherALOHACARE KANEOHE
HI02439705Medicaid
02656404OtherALOHACARE HONOLULU
02656407OtherALOHACARE AIEA