| Leeward Community & Therapy Supports | |
|
91-1170 Mikohu St Apt 40c Ewa Beach HI 96706-4317 | |
| (505) 429-5731 | |
| Not Available |
| Full Name | Leeward Community & Therapy Supports |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 91-1170 Mikohu St Apt 40c, Ewa Beach, Hawaii |
| Authorized Official Name and Position | Taryn Joy Mai Valdez Ivers (OWNER) |
| Authorized Official Contact | 5054295731 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Leeward Community & Therapy Supports 94-245 Leoku St Unit 970334 Waipahu HI 96797-7014 Ph: (808) 466-9111 | Leeward Community & Therapy Supports 91-1170 Mikohu St Apt 40c Ewa Beach HI 96706-4317 Ph: (505) 429-5731 |
| NPI Number | 1275289407 |
|---|---|
| Provider Enumeration Date | 02/25/2022 |
| Last Update Date | 01/19/2023 |
| Certification Date | 01/19/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275289407 | NPI | - | NPPES |
| 001525 | Medicaid | HI | |
| 003149 | Medicaid | HI |
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