Provider Demographics
NPI:1720314602
Name:BEHAVIORAL COUNSELING AND RESEARCH CENTER
Entity Type:Organization
Organization Name:BEHAVIORAL COUNSELING AND RESEARCH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPPORT SERVICES MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CARLA
Authorized Official - Middle Name:
Authorized Official - Last Name:GROSS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-945-3055
Mailing Address - Street 1:1833 KALAKAUA AVE STE 406
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96815-1515
Mailing Address - Country:US
Mailing Address - Phone:808-945-3055
Mailing Address - Fax:808-945-3064
Practice Address - Street 1:1833 KALAKAUA AVE STE 406
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96815-1515
Practice Address - Country:US
Practice Address - Phone:808-945-3055
Practice Address - Fax:808-945-3064
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-27
Last Update Date:2009-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health