| Advanced Wellness And Recovery Llc | |
|
75-5722 Kuakini Hwy Ste 103 Kailua Kona HI 96740-1721 | |
| (808) 327-9609 | |
| (808) 327-9607 |
| Full Name | Advanced Wellness And Recovery Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 75-5722 Kuakini Hwy Ste 103, Kailua Kona, Hawaii |
| Authorized Official Name and Position | Hardeep Reddick (OWNER) |
| Authorized Official Contact | 8083279609 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Advanced Wellness And Recovery Llc 75-5722 Kuakini Hwy Ste 103 Kailua Kona HI 96740-1721 Ph: (808) 327-9609 | Advanced Wellness And Recovery Llc 75-5722 Kuakini Hwy Ste 103 Kailua Kona HI 96740-1721 Ph: (808) 327-9609 |
| NPI Number | 1811777808 |
|---|---|
| Provider Enumeration Date | 10/05/2023 |
| Last Update Date | 01/18/2024 |
| Medicare PECOS PAC ID | 0648617753 |
|---|---|
| Medicare Enrollment ID | O20240326000245 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811777808 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Ky H Le |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073560025 PECOS PAC ID: 7315962206 Enrollment ID: I20051010000940 |
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