| Organization Name: | COMMUNITY CLINIC OF MAUI INC |
| NPI Number: | 1053564526 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DANA ALONZO-HOWETH (EXECUTIVE DIRECTOR) |
| Mailing Address: | 15 Ipu Aumakua Ln Lahaina |
| State: | HI US |
| Postal Code: | 967611193 |
| Phone Number: | 8086677598 |
| Fax Number: | 8086677492 |
| NPI Enumeration Date: | 10/28/2008 |
| NPI Last Update Date: | 06/09/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QC1500X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Community Health |
| Taxonomy Definition: | |