| The Green Will Conservancy Inc | |
|
14-803b Seaview Road Nanawale Estates Pahoa HI 96778-1341 | |
| (808) 965-5349 | |
| (808) 965-5036 |
| Full Name | The Green Will Conservancy Inc |
|---|---|
| Speciality | Social Worker |
| Location | 14-803b Seaview Road, Pahoa, Hawaii |
| Authorized Official Name and Position | Frank Capatch (DIRECTOR) |
| Authorized Official Contact | 8089655349 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Green Will Conservancy Inc Po Box 1341 Pahoa HI 96778-1341 Ph: (808) 965-5349 | The Green Will Conservancy Inc 14-803b Seaview Road Nanawale Estates Pahoa HI 96778-1341 Ph: (808) 965-5349 |
| NPI Number | 1588971303 |
|---|---|
| Provider Enumeration Date | 09/01/2010 |
| Last Update Date | 09/01/2010 |
| Medicare PECOS PAC ID | 7416332366 |
|---|---|
| Medicare Enrollment ID | O20220914000550 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588971303 | NPI | - | NPPES |
| 00C0222764 | Other | HI | TRICARE |
| 00C0222764 | Other | HI | HMSA BLUE CROSS BLUE SHIELD OF HAWAII |
| 00C0222764 | Other | HI | HMSA 65C PLUS |
| 00C0222764 | Other | HI | HMSA PPO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 3265 (Hawaii) | Primary |
| 1041C0700X | Social Worker - Clinical | 3331 (Hawaii) | Secondary |
| Provider Name | Bryan E Houston |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053070946 PECOS PAC ID: 3870978729 Enrollment ID: I20230227000616 |
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