1881960300 NPI number — ONE HOLISTIC PLACE

Table of content: (NPI 1881960300)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881960300 NPI number — ONE HOLISTIC PLACE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ONE HOLISTIC PLACE
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1881960300
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1584
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
KAPAAU
Provider Business Mailing Address State Name:
HI
Provider Business Mailing Address Postal Code:
96755-1441
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
68-1886 E KAUPAPA PL
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WAIKOLOA
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96738-5202
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-756-3883
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/29/2012

Additional Information

Authorized Official

Authorized Official Last Name:
ALLEN
Authorized Official First Name:
RACHEL
Authorized Official Middle Name:
ELIZABETH
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
808-756-3883

Provider Taxonomy Codes

  • Taxonomy code: 251V00000X , registered in the state of HI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1609036870 . This is a "NPI" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".




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