Provider Demographics
NPI:1740358118
Name:THE ALCOHOLIC REHABILITATION SERVICES OF HAWAII INC
Entity type:Organization
Organization Name:THE ALCOHOLIC REHABILITATION SERVICES OF HAWAII INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:TECHNOLOGY DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:OLIVER
Authorized Official - Middle Name:C
Authorized Official - Last Name:OCAMPO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-236-2600
Mailing Address - Street 1:45-845 POOKELA ST
Mailing Address - Street 2:
Mailing Address - City:KANEOHE
Mailing Address - State:HI
Mailing Address - Zip Code:96744-5700
Mailing Address - Country:US
Mailing Address - Phone:808-236-2600
Mailing Address - Fax:808-235-6564
Practice Address - Street 1:45-845 POOKELA ST
Practice Address - Street 2:
Practice Address - City:KANEOHE
Practice Address - State:HI
Practice Address - Zip Code:96744-5700
Practice Address - Country:US
Practice Address - Phone:808-236-2600
Practice Address - Fax:808-236-2626
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-01
Last Update Date:2014-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI52STF324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility