| Grace M. Barrientos | |
|
305 Wailuku Dr Ste 5a Hilo HI 96720-2488 | |
| (808) 785-3293 | |
| (808) 443-0070 |
| Full Name | Grace M. Barrientos |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 305 Wailuku Dr Ste 5a, Hilo, Hawaii |
| Authorized Official Name and Position | Grace Madarang Barrientos (OWNER) |
| Authorized Official Contact | 8088954850 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Grace M. Barrientos Po Box 4624 Hilo HI 96720-0624 Ph: (808) 895-4850 | Grace M. Barrientos 305 Wailuku Dr Ste 5a Hilo HI 96720-2488 Ph: (808) 785-3293 |
| NPI Number | 1811325434 |
|---|---|
| Provider Enumeration Date | 10/16/2013 |
| Last Update Date | 10/17/2019 |
| Medicare PECOS PAC ID | 5597001479 |
|---|---|
| Medicare Enrollment ID | O20191125002677 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811325434 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | LCSW 3888 (Hawaii) | Primary |
| Provider Name | Brenda J Levesque |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679711162 PECOS PAC ID: 3072842871 Enrollment ID: I20190904000202 |
| Provider Name | Grace Madarang Barrientos |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1780843359 PECOS PAC ID: 8224261599 Enrollment ID: I20191216002643 |
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