BEACON OF LASTING CHANGE, LLC – NPI #1396404877
Clinic/Center

An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults.

BEACON OF LASTING CHANGE, LLC is an AHC clinic located in HONOLULU, HI. NPPES has assigned the NPI number 1396404877 to BEACON OF LASTING CHANGE, LLC on December 13, 2021. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 261QM0850X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Adult Mental Health

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for BEACON OF LASTING CHANGE, LLC below.

NPI Profile for
BEACON OF LASTING CHANGE, LLC

NPI Number
1396404877
Enumeration Date

(more than 4 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
BEACON OF LASTING CHANGE, LLC
Primary location
438 HOBRON LN STE 311
HONOLULU, HI 96815-1229
Phone: (808) 600-1132 Fax:
Mailing address
5984 GANNET AVE
EWA BEACH, HI 96706-3239
Phone: (808) 600-1132 Fax:
Organization Subpart
No
Authorized Official
MAITA MARKS
MANAGER
Phone: (808) 600-1132
Updated
Certification Date
Dec 13, 2021

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QM0850X
- Clinic/Center / Adult Mental Health (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.