| Heavenly Star Llc | |
|
99-124 Kohomua St 15c Aiea HI 96701-3876 | |
| (808) 781-7984 | |
| Not Available |
| Full Name | Heavenly Star Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 99-124 Kohomua St, Aiea, Hawaii |
| Authorized Official Name and Position | Rena Mae Nalani Takushi (LICENSED CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 8087817984 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Heavenly Star Llc 99-124 Kohomua St 15c Aiea HI 96701-3876 Ph: (808) 781-7984 | Heavenly Star Llc 99-124 Kohomua St 15c Aiea HI 96701-3876 Ph: (808) 781-7984 |
| NPI Number | 1306201629 |
|---|---|
| Provider Enumeration Date | 12/31/2015 |
| Last Update Date | 12/31/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306201629 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 4054 (Hawaii) | Primary |
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