| Beacon Of Lasting Change, Llc | |
|
438 Hobron Ln Ste 311 Honolulu HI 96815-1229 | |
| (808) 600-1132 | |
| Not Available |
| Full Name | Beacon Of Lasting Change, Llc |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 438 Hobron Ln Ste 311, Honolulu, Hawaii |
| Authorized Official Name and Position | Maita Marks (MANAGER) |
| Authorized Official Contact | 8086001132 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Beacon Of Lasting Change, Llc 5984 Gannet Ave Ewa Beach HI 96706-3239 Ph: (808) 600-1132 | Beacon Of Lasting Change, Llc 438 Hobron Ln Ste 311 Honolulu HI 96815-1229 Ph: (808) 600-1132 |
| NPI Number | 1396404877 |
|---|---|
| Provider Enumeration Date | 12/13/2021 |
| Last Update Date | 12/13/2021 |
| Certification Date | 12/13/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396404877 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
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