| Hale Kipa, Inc. | |
|
91-2128 Old Ft Weaver Rd Ewa Beach HI 96706-1911 | |
| (808) 589-1829 | |
| (808) 589-2610 |
| Full Name | Hale Kipa, Inc. |
|---|---|
| Speciality | Residential Treatment Facility, Emotionally Disturbed Children |
| Location | 91-2128 Old Ft Weaver Rd, Ewa Beach, Hawaii |
| Authorized Official Name and Position | Venus Venus Rosete-medeiros (CEO) |
| Authorized Official Contact | 8085891829 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Hale Kipa, Inc. 91-2128 Old Ft Weaver Rd Ewa Beach HI 96706-1911 Ph: (808) 589-1829 | Hale Kipa, Inc. 91-2128 Old Ft Weaver Rd Ewa Beach HI 96706-1911 Ph: (808) 589-1829 |
| NPI Number | 1164627246 |
|---|---|
| Provider Enumeration Date | 06/18/2007 |
| Last Update Date | 05/11/2023 |
| Certification Date | 05/11/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164627246 | NPI | - | NPPES |
| W2005550002 | Other | HI | HAWAII TAX ID |
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