| New Waves Wellness Center, Inc. | |
|
3660 Baldwin Ave Makawao HI 96768-7503 | |
| (808) 205-8055 | |
| Not Available |
| Full Name | New Waves Wellness Center, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 3660 Baldwin Ave, Makawao, Hawaii |
| Authorized Official Name and Position | Teri Holter (TREASURER) |
| Authorized Official Contact | 8082058055 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| New Waves Wellness Center, Inc. Po Box 458 Makawao HI 96768-0458 Ph: (808) 205-8055 | New Waves Wellness Center, Inc. 3660 Baldwin Ave Makawao HI 96768-7503 Ph: (808) 205-8055 |
| NPI Number | 1598049140 |
|---|---|
| Provider Enumeration Date | 09/30/2011 |
| Last Update Date | 09/30/2011 |
| Medicare PECOS PAC ID | 1456523034 |
|---|---|
| Medicare Enrollment ID | O20111003000614 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598049140 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | LCSW3180 (Hawaii) | Primary |
| Provider Name | Teri L Holter |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801018510 PECOS PAC ID: 1052340718 Enrollment ID: I20050812000069 |
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