HALE KIPA, INC. (NPI# 1164627246) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164627246 |
| Entity Type | Organization |
| Organization Name | HALE KIPA, INC. |
| Practice Address |
615 Piikoi St Suite 203 Honolulu HI 96814-3116 |
| Practice Telephone | 8085891829 |
| Practice Fax Number | 8085892610 |
| Mailing Telephone | 8085891829 |
| Mailing Fax Number | 8085892610 |
| Enumeration Date | 2007-06-18 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. ERNEST PLETAN-CROSS (CEO) |
| Authorized Official Telephone | 8085891829 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | W2005550002 | HI | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| HI | HAWAII TAX ID | W2005550002 | 01 |
| Street Address |
615 PIIKOI ST SUITE 203 |
| City | HONOLULU |
| State | HI |
| Zip Code | 96814-3116 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154310639 | Robin B Welch | Psychologist | 615 Piikoi St, Suite 1603, Honolulu, HI 96814-3116 | 2005-10-18 |
| 1770198921 | Bessie Mae Bethany Star Ertel | Behavior Technician | 615 Piikoi St, Honolulu, HI 96814-3116 | 2020-09-14 |
| 1306346994 | Allison Marie Brown | Counselor | 615 Piikoi St, Honolulu, HI 96814-3116 | 2018-02-20 |
| 1154849453 | Khongorzul Battsooj | Counselor | 615 Piikoi St, 203, Honolulu, HI 96814 | 2017-09-07 |
| 1083145684 | Susan Palazzo | Registered Nurse | 615 Piikoi St, Suite 1406, Honolulu, HI 96814-3116 | 2017-03-24 |
| 1508215948 | David William Victorino Jr. | Counselor | 615 Piikoi St, Honolulu, HI 96814-3116 | 2016-06-07 |
| 1376991778 | Arielle Badeaux | Peer Specialist | 615 Piikoi St, Honolulu, HI 96814-3116 | 2016-05-26 |
| 1003263237 | Lindsey King | Psychologist | 615 Piikoi St, Suite 1605, Honolulu, HI 96814-3116 | 2016-05-18 |
| 1295194140 | Ellen Swann Wright | Marriage & Family Therapist | 615 Piikoi St, Suite #203, Honolulu, HI 96814-3116 | 2016-02-21 |
| 1053784793 | Robyn Trivette | Counselor | 615 Piikoi St, Ste 203, Honolulu, HI 96814-3116 | 2015-11-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336746478 | Ross Thomas Fujimori Pascual | Pharmacist | 750 Keeaumoku Street, Honolulu, HI 96814 | 2020-10-01 |
| 1336755263 | Hawaikikitelehealth LLC | Counselor | 1108 Auwahi Street, 1506, Honolulu, HI 96814 | 2020-09-16 |
| 1225647324 | Metaphysio Hawaii LLC | Physical Therapist | 1350 South King Street Suite 303, Honolulu, HI 96814 | 2020-07-24 |
| 1114572161 | Alyssa Foster | Social Worker | 1314 S King St Ste 1152, Honolulu, HI 96814 | 2019-08-07 |
| 1871157628 | Ala Moana Walk-in Medical Clinic, Inc | Nurse Practitioner | 410 Atkinson Dr., Level 3, Honolulu, HI 96814 | 2019-04-26 |
| 1528524014 | Regenerative Living Private Duty Inc | Home Health Aide | 1314 South King Street Ste 853, Honolulu, HI 96814 | 2019-02-20 |
| 1295299428 | Kaori Utashiro | Massage Therapist | 1450 Ala Moana Blvd. Suite1227, Honolulu, HI 96814 | 2019-01-22 |
| 1619444569 | Optimized Health LLC | General Practice | 1441 Kapiolani Blvd Ste 1114, #23464, Honolulu, HI 96814 | 2018-10-30 |
| 1356823785 | Tara Yamauchi-lum LLC | Marriage & Family Therapist | 615 Piikoi Street Suite 1109, Honolulu, HI 96814 | 2018-09-01 |
| 1992283980 | Sonia Q. Cosio, D.d.s | Dentist | 1441 Kapiolani Blvd #518, Honolulu, HI 96814 | 2018-08-01 |
| Find all providers in zip 96814 | ||||
| Taxonomy Code | 322D00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Emotionally Disturbed Children |
| A provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment. |
| Notes: Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336563154 | Michael James | Residential Treatment Facility, Emotionally Disturbed Children | 47-343 Lulani St, Kaneohe, HI 96744-4716 | 2014-02-13 |
| 1104192970 | Marimed Foundation | Residential Treatment Facility, Emotionally Disturbed Children | 47-292 Ahaolelo Rd, Kaneohe, HI 96744-4803 | 2012-03-27 |
| 1417152828 | Hale Opio Kauai, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 2959 Umi St, Lihue, HI 96766-1806 | 2007-06-15 |
| 1124145149 | Kids Behavioral Health of Hawaii, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 440 Kapiolani St, Hilo, HI 96720-3937 | 2007-03-23 |
| 1609132323 | Pacific Quest | Residential Treatment Facility, Emotionally Disturbed Children | 15 Kanoa St, Hilo, HI 96720-2426 | 2012-04-06 |
| 1659685493 | Pacific Quest Corporation | Residential Treatment Facility, Emotionally Disturbed Children | 15 Kanoa St, Hilo, HI 96720-2426 | 2010-08-04 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.