Provider Demographics
NPI:1871905711
Name:BEHAVIORAL AND THERAPEUTIC SERVICES OF HAWAII LLC
Entity type:Organization
Organization Name:BEHAVIORAL AND THERAPEUTIC SERVICES OF HAWAII LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:FRED
Authorized Official - Middle Name:KEKINO
Authorized Official - Last Name:YUEN
Authorized Official - Suffix:
Authorized Official - Credentials:MS, BCBA
Authorized Official - Phone:808-780-0014
Mailing Address - Street 1:1330 WILDER AVE APT 319
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96822-4272
Mailing Address - Country:US
Mailing Address - Phone:808-306-0429
Mailing Address - Fax:808-200-4978
Practice Address - Street 1:710 PALEKAUA ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96816-4755
Practice Address - Country:US
Practice Address - Phone:808-780-0014
Practice Address - Fax:808-356-1609
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-27
Last Update Date:2019-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Multi-Specialty
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior AnalystGroup - Multi-Specialty
No106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Multi-Specialty