BOBBY BENSON CENTER (NPI# 1306904461) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306904461 |
| Entity Type | Organization |
| Organization Name | BOBBY BENSON CENTER |
| Practice Address |
56-660 Kamehameha Hwy Kahuku HI 96731-2210 |
| Practice Telephone | 8082937555 |
| Practice Fax Number | 8082937196 |
| Mailing Telephone | 8082937555 |
| Mailing Fax Number | 8082937196 |
| Enumeration Date | 2006-12-04 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. JEFFRIE WAGNER (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 8082937555 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3245S0500X |
Substance Abuse Rehabilitation Facility Specialization: Substance Abuse Treatment, Children |
53-STF | HI | Residential Treatment Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962659540 | Bobby Benson Center | Community Based Residential Treatment Facility, Mental Illness | 56-660 Kamehameha Hwy, Kahuku, HI 96731-2210 | 2008-08-26 |
| Street Address |
56-660 KAMEHAMEHA HWY |
| City | KAHUKU |
| State | HI |
| Zip Code | 96731-2210 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679171078 | Tiffany Kristine Gougeon | Registered Nurse | 56-660 Kamehameha Hwy, Kahuku, HI 96731-2210 | 2020-10-16 |
| 1033717665 | Luseane Latu | Counselor | 56-660 Kamehameha Hwy, Kahuku, HI 96731-2210 | 2020-10-15 |
| 1114544145 | Melita Maramanisiga Matanatabu | Counselor | 56-660 Kamehameha Hwy, Kahuku, HI 96731-2210 | 2020-06-25 |
| 1417573478 | Soli K.m. Afalava | Counselor | 56-660 Kamehameha Hwy, Kahuku, HI 96731-2210 | 2020-06-24 |
| 1942826391 | Josevata Dredre Damuni | Counselor | 56-660 Kamehameha Hwy, Kahuku, HI 96731-2210 | 2020-06-22 |
| 1013533389 | Sione Ford Naeata | Counselor | 56-660 Kamehameha Hwy, Kahuku, HI 96731-2210 | 2020-06-22 |
| 1710503263 | Isabella Dearaujo | Counselor | 56-660 Kamehameha Hwy, Kahuku, HI 96731-2210 | 2020-06-21 |
| 1194341990 | John Labarre Moleni | Counselor | 56-660 Kamehameha Hwy, Kahuku, HI 96731-2210 | 2020-06-18 |
| 1316563265 | Kolokesa Piutau | Counselor | 56-660 Kamehameha Hwy, Kahuku, HI 96731-2210 | 2020-06-16 |
| 1982220810 | Cameron Clay Walker | Counselor | 56-660 Kamehameha Hwy, Kahuku, HI 96731-2210 | 2020-06-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174149405 | Teniiti Taie Burennatu | Counselor | 55-660 Kamehameha Hwy, Kahuku, HI 96731 | 2020-06-23 |
| 1568909109 | Maia Miller | Specialist/Technologist | 46-590 Kamehameha Hwy, Kahuku High School, Kahuku, HI 96731 | 2017-01-20 |
| 1063766079 | Ko'olauloa Health Center | Clinic/Center | 56-490 Kamehameha Hwy R-building Rm 104, Kahuku, HI 96731 | 2012-10-30 |
| 1295097830 | Kerry Saitia Moea'i | Social Worker | 56-395 Huehu St., Kahuku, HI 96731 | 2012-06-11 |
| 1114194073 | Jason Hughes | Internal Medicine | 56-117 Pualalea Street, Kahuku, HI 96731 | 2008-05-09 |
| 1942341318 | Kaiser Foundation Health Plan Inc | Pharmacy | 56 700 Kamehameha Highway, Kahuku, HI 96731 | 2007-02-09 |
| 1659438281 | Carol Francine Green | Social Worker | 56 565 Kamehameha Hwy, Kahuku, HI 96731 | 2007-01-02 |
| 1578508602 | Douglas A Sutherland | Pediatrics | 56 119 Pualalea St, Kahuku, HI 96731 | 2006-06-20 |
| 1528026952 | Ko'olauloa Health Center | Clinic/Center | 56-119 Pualalea St., Kahuku, HI 96731 | 2006-05-03 |
| 1144683012 | Tara Reed | Internal Medicine | 56-119 Pualalea St, Kahuku, HI 96731 | 2016-03-30 |
| Find all providers in zip 96731 | ||||
| Taxonomy Code | 3245S0500X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| Specialization | Substance Abuse Treatment, Children |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of children with disorders in the use of drugs, alcohol, and other substances. Medical and supportive counseling services and education services are included. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316277072 | The Bobby Benson Center | Substance Abuse Rehabilitation Facility | 56-660 Kamehameha Hwy, Kahuku, HI 96731-2210 | 2009-12-31 |
| 1033366216 | The Bobby Benson Center | Substance Abuse Rehabilitation Facility | 56-660 Kamehameha Hwy, Kahuku, HI 96731-2210 | 2008-08-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184101446 | The Salvation Army | Substance Abuse Rehabilitation Facility | 105 Hokulani Street, Hilo, HI 96720 | 2018-07-19 |
| 1740454594 | Marimed Foundation for Island Health Care Training | Substance Abuse Rehabilitation Facility | 45-021 Likeke Pl, Kaneohe, HI 96744-2426 | 2008-04-14 |
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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.