| Mental Health Kokua | |
|
680 Iwilei Rd Ste 600 Honolulu HI 96817-5393 | |
| (808) 737-2523 | |
| Not Available |
| Full Name | Mental Health Kokua |
|---|---|
| Speciality | Case Management |
| Location | 680 Iwilei Rd Ste 600, Honolulu, Hawaii |
| Authorized Official Name and Position | Greg Payton (CEO/ED) |
| Authorized Official Contact | 8087372523 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mental Health Kokua 680 Iwilei Rd Ste 600 Honolulu HI 96817-5393 Ph: (808) 737-2523 | Mental Health Kokua 680 Iwilei Rd Ste 600 Honolulu HI 96817-5393 Ph: (808) 737-2523 |
| NPI Number | 1114218625 |
|---|---|
| Provider Enumeration Date | 05/02/2011 |
| Last Update Date | 11/13/2024 |
| Certification Date | 11/13/2024 |
| Medicare PECOS PAC ID | 1355569864 |
|---|---|
| Medicare Enrollment ID | O20140826000066 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114218625 | NPI | - | NPPES |
| 1033258348 | Other | HI | HAWAII DEPARTMENT OF HEALTH, ADULT MENTAL HEALTH DIVISION |
| Provider Name | Carissa Manreal Bolo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023882081 PECOS PAC ID: 9133663321 Enrollment ID: I20240628001225 |
| Provider Name | Mary K Mossman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386860971 PECOS PAC ID: 3274568837 Enrollment ID: I20240724001219 |
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