| Mana Recovery Llc | |
|
1063 Lower Main St Ste C211a213 Wailuku HI 96793-2038 | |
| (808) 867-9268 | |
| Not Available |
| Full Name | Mana Recovery Llc |
|---|---|
| Speciality | Substance Abuse Rehabilitation Facility |
| Location | 1063 Lower Main St Ste C211a213, Wailuku, Hawaii |
| Authorized Official Name and Position | Owen James Campbell (CEO/OWNER) |
| Authorized Official Contact | 5164741951 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mana Recovery Llc Po Box 736 Haiku HI 96708-0736 Ph: () - | Mana Recovery Llc 1063 Lower Main St Ste C211a213 Wailuku HI 96793-2038 Ph: (808) 867-9268 |
| NPI Number | 1588394472 |
|---|---|
| Provider Enumeration Date | 06/14/2022 |
| Last Update Date | 06/13/2023 |
| Certification Date | 06/13/2023 |
| Medicare PECOS PAC ID | 4284092321 |
|---|---|
| Medicare Enrollment ID | O20230621002369 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588394472 | NPI | - | NPPES |
| 8042992 | Medicaid | HI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| 324500000X | Substance Abuse Rehabilitation Facility | (* (Not Available)) | Primary |
| Provider Name | Rosalie J Schreiber |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568530632 PECOS PAC ID: 8628090255 Enrollment ID: I20051227000111 |
| Provider Name | Eileen Anne Lang |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063889822 PECOS PAC ID: 3274994041 Enrollment ID: I20230727000851 |
| Provider Name | Hilary E Helkenn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922705680 PECOS PAC ID: 0244687069 Enrollment ID: I20231115002114 |
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