Provider Demographics
NPI:1679313811
Name:HO'OLOKAHI WELLNESS, LLC
Entity type:Organization
Organization Name:HO'OLOKAHI WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIC NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:WERNER
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:808-256-8589
Mailing Address - Street 1:45-1123 KAMEHAMEHA HWY STE D
Mailing Address - Street 2:
Mailing Address - City:KANEOHE
Mailing Address - State:HI
Mailing Address - Zip Code:96744-3252
Mailing Address - Country:US
Mailing Address - Phone:808-744-0222
Mailing Address - Fax:
Practice Address - Street 1:45-1123 KAMEHAMEHA HWY STE D
Practice Address - Street 2:
Practice Address - City:KANEOHE
Practice Address - State:HI
Practice Address - Zip Code:96744-3252
Practice Address - Country:US
Practice Address - Phone:808-744-0222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-27
Last Update Date:2024-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health