| Cheryl Jorgensen Llc | |
|
688 Kinoole St Ste 218a Hilo HI 96720-3869 | |
| (808) 935-9396 | |
| (808) 207-6543 |
| Full Name | Cheryl Jorgensen Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 688 Kinoole St Ste 218a, Hilo, Hawaii |
| Authorized Official Name and Position | Cheryl Jorgensen (MEMBER) |
| Authorized Official Contact | 8089359396 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cheryl Jorgensen Llc 688 Kinoole St Ste 218a Hilo HI 96720-3869 Ph: (808) 935-9396 | Cheryl Jorgensen Llc 688 Kinoole St Ste 218a Hilo HI 96720-3869 Ph: (808) 935-9396 |
| NPI Number | 1033873005 |
|---|---|
| Provider Enumeration Date | 10/26/2021 |
| Last Update Date | 10/26/2021 |
| Certification Date | 10/26/2021 |
| Medicare PECOS PAC ID | 4082058938 |
|---|---|
| Medicare Enrollment ID | O20240219002071 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033873005 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Cheryl Jorgensen |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1114207156 PECOS PAC ID: 0345684296 Enrollment ID: I20240219002488 |
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