| Bannan Enterprise Llc | |
|
59-777 Pupukea Rd Haleiwa HI 96712-9560 | |
| (808) 388-4974 | |
| Not Available |
| Full Name | Bannan Enterprise Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 59-777 Pupukea Rd, Haleiwa, Hawaii |
| Authorized Official Name and Position | Sonja Christine Bigalke-bannan (OWNER) |
| Authorized Official Contact | 8083884974 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bannan Enterprise Llc 1985 Puowaina Dr Honolulu HI 96813-1732 Ph: (808) 388-4974 | Bannan Enterprise Llc 59-777 Pupukea Rd Haleiwa HI 96712-9560 Ph: (808) 388-4974 |
| NPI Number | 1578136586 |
|---|---|
| Provider Enumeration Date | 07/19/2021 |
| Last Update Date | 07/19/2021 |
| Certification Date | 07/19/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578136586 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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