Provider Demographics
NPI:1932960374
Name:HE ALA HOU O KE OLA INC
Entity Type:Organization
Organization Name:HE ALA HOU O KE OLA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:DR
Authorized Official - First Name:BENDY
Authorized Official - Middle Name:
Authorized Official - Last Name:SYSOMBOUN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-723-6390
Mailing Address - Street 1:531 PUUHALE RD
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96819-3241
Mailing Address - Country:US
Mailing Address - Phone:808-807-0770
Mailing Address - Fax:
Practice Address - Street 1:531 PUUHALE RD
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96819-3241
Practice Address - Country:US
Practice Address - Phone:808-807-0770
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-23
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
No261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
No320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
No324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility