Provider Demographics
NPI:1740929108
Name:SPILL THE TEA CAFE
Entity type:Organization
Organization Name:SPILL THE TEA CAFE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KRIZIA
Authorized Official - Middle Name:
Authorized Official - Last Name:LUGARO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-797-4970
Mailing Address - Street 1:47-283 HUI IWA ST APT A
Mailing Address - Street 2:
Mailing Address - City:KANEOHE
Mailing Address - State:HI
Mailing Address - Zip Code:96744-4359
Mailing Address - Country:US
Mailing Address - Phone:808-364-7592
Mailing Address - Fax:
Practice Address - Street 1:1034 QUEEN ST FL 2
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-4116
Practice Address - Country:US
Practice Address - Phone:808-797-4970
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-02
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health