Provider Demographics
NPI:1720697170
Name:HAWAII HOLISTIC HEALTH NETWORK LLC
Entity Type:Organization
Organization Name:HAWAII HOLISTIC HEALTH NETWORK LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:OMAYRA
Authorized Official - Middle Name:G
Authorized Official - Last Name:ROCCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-359-3336
Mailing Address - Street 1:25 KUINEHE PL
Mailing Address - Street 2:
Mailing Address - City:MAKAWAO
Mailing Address - State:HI
Mailing Address - Zip Code:96768-8285
Mailing Address - Country:US
Mailing Address - Phone:719-439-7022
Mailing Address - Fax:
Practice Address - Street 1:7 AEWA PL
Practice Address - Street 2:SUITE 12
Practice Address - City:PUKALANI
Practice Address - State:HI
Practice Address - Zip Code:96768
Practice Address - Country:US
Practice Address - Phone:808-359-3336
Practice Address - Fax:808-572-0394
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-30
Last Update Date:2020-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty