Dorene Toutant Llc | |
50 Kaukini Loop Wailuku HI 96793-5755 | |
(626) 755-8726 | |
Not Available |
Full Name | Dorene Toutant Llc |
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Speciality | Community/Behavioral Health |
Location | 50 Kaukini Loop, Wailuku, Hawaii |
Authorized Official Name and Position | Dorene Catherine Toutant (OWNER) |
Authorized Official Contact | 6267558726 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Dorene Toutant Llc 1704 Wili Pa Loop 272 Wailuku HI 96793-1240 Ph: (626) 755-8726 | Dorene Toutant Llc 50 Kaukini Loop Wailuku HI 96793-5755 Ph: (626) 755-8726 |
NPI Number | 1932648474 |
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Provider Enumeration Date | 02/16/2017 |
Last Update Date | 02/16/2017 |
Medicare PECOS PAC ID | 6305123092 |
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Medicare Enrollment ID | O20170505001704 |
Identifier | Type | State | Issuer |
---|---|---|---|
1932648474 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
251S00000X | Community/behavioral Health | 4199 (Hawaii) | Primary |
Provider Name | Dorene Toutant |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1114466190 PECOS PAC ID: 7012294705 Enrollment ID: I20170505001804 |
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