OrganizationActive
Beacon of Lasting Change, LLC
NPI 1396404877 · Adult Mental Health Clinic/Center · Honolulu, HI
Provider details
- NPI number
- 1396404877
- Entity type
- Organization
- Primary specialty
- Adult Mental Health Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Maita Marks, Manager(808) 600-1132
Specialties & taxonomies
Ambulatory Health Care Facilities
Practice location
438 Hobron Ln Ste 311
Honolulu, HI 96815-1229
Phone: (808) 600-1132
Approximate (ZIP-level) locationGet directions
Mailing address
5984 Gannet Ave
Ewa Beach, HI 96706-3239
Registry dates
- Enumerated
- 2021-12-13
- Last updated
- 2021-12-13
- Certified
- 2021-12-13
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.