| Soul Spot Non-profit Inc | |
|
3417e Poipu Rd Ste 107a Koloa HI 96756-8528 | |
| (808) 431-3332 | |
| Not Available |
| Full Name | Soul Spot Non-profit Inc |
|---|---|
| Speciality | Counselor |
| Location | 3417e Poipu Rd Ste 107a, Koloa, Hawaii |
| Authorized Official Name and Position | Vaughn Lee Adamson (PROGRAM DIRECTOR) |
| Authorized Official Contact | 6197485360 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Soul Spot Non-profit Inc 3417e Poipu Rd Ste 107a Koloa HI 96756-8528 Ph: (808) 431-3332 | Soul Spot Non-profit Inc 3417e Poipu Rd Ste 107a Koloa HI 96756-8528 Ph: (808) 431-3332 |
| NPI Number | 1912707076 |
|---|---|
| Provider Enumeration Date | 03/18/2025 |
| Last Update Date | 03/18/2025 |
| Certification Date | 03/18/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912707076 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Primary |
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