Provider Demographics
NPI:1841070687
Name:JEREMIAH S. BRENNAN
Entity type:Organization
Organization Name:JEREMIAH S. BRENNAN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/SOLE PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:JEREMIAH
Authorized Official - Middle Name:
Authorized Official - Last Name:BRENNAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-688-8020
Mailing Address - Street 1:PO BOX 37041
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96837-0041
Mailing Address - Country:US
Mailing Address - Phone:808-688-8020
Mailing Address - Fax:808-260-1736
Practice Address - Street 1:46-001 KAMEHAMEHA HWY STE 217
Practice Address - Street 2:
Practice Address - City:KANEOHE
Practice Address - State:HI
Practice Address - Zip Code:96744-3732
Practice Address - Country:US
Practice Address - Phone:808-688-8020
Practice Address - Fax:808-260-1736
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-29
Last Update Date:2023-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty