| Organization Name: | DSM THERAPEUTIC AND WELLNESS CENTER LLC |
| NPI Number: | 1205216959 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DANELLE S MEDEIROS (MEMBER MANAGER) |
| Mailing Address: | 91-1100 Paaoloulu Way Kapolei |
| State: | HI US |
| Postal Code: | 967073102 |
| Phone Number: | 8083873922 |
| Fax Number: | 8086720104 |
| NPI Enumeration Date: | 06/08/2015 |
| NPI Last Update Date: | 06/08/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC1900X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | HI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Counseling |
| Taxonomy Definition: | |