Provider Demographics
NPI:1720741473
Name:KAUHALE HEALING LLC
Entity Type:Organization
Organization Name:KAUHALE HEALING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MBR
Authorized Official - Prefix:
Authorized Official - First Name:DAMIEN
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:808-480-1247
Mailing Address - Street 1:PO BOX 4920
Mailing Address - Street 2:
Mailing Address - City:KAILUA KONA
Mailing Address - State:HI
Mailing Address - Zip Code:96745-4920
Mailing Address - Country:US
Mailing Address - Phone:808-480-1247
Mailing Address - Fax:
Practice Address - Street 1:75-5706 HANAMA PL STE 110
Practice Address - Street 2:
Practice Address - City:KAILUA KONA
Practice Address - State:HI
Practice Address - Zip Code:96740-1713
Practice Address - Country:US
Practice Address - Phone:808-480-1247
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-20
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty