| Organization Name: | FIVE MOUNTAINS HAWAII, INC |
| NPI Number: | 1215359989 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CLAREN K KEALOHA-BEAUDET (DIRECTOR) |
| Mailing Address: | 65-1158 Mamalahoa Hwy Suite 2d Kamuela |
| State: | HI US |
| Postal Code: | 967438442 |
| Phone Number: | 8088855900 |
| Fax Number: | |
| NPI Enumeration Date: | 01/14/2014 |
| NPI Last Update Date: | 01/14/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |