Provider Demographics
NPI:1831861913
Name:PAKOLEA SUPPORT SERVICES
Entity type:Organization
Organization Name:PAKOLEA SUPPORT SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:LA REINA
Authorized Official - Middle Name:
Authorized Official - Last Name:KAMALANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-828-2885
Mailing Address - Street 1:4151 MOMI ST
Mailing Address - Street 2:
Mailing Address - City:KILAUEA
Mailing Address - State:HI
Mailing Address - Zip Code:96754-5312
Mailing Address - Country:US
Mailing Address - Phone:808-639-5896
Mailing Address - Fax:888-461-0904
Practice Address - Street 1:1895 HALEUKANA ST FL 2
Practice Address - Street 2:
Practice Address - City:LIHUE
Practice Address - State:HI
Practice Address - Zip Code:96766-9072
Practice Address - Country:US
Practice Address - Phone:808-346-6690
Practice Address - Fax:888-461-0904
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HO'OHELE INITIATIVE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-09-28
Last Update Date:2021-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty