Provider Demographics
NPI:1558109744
Name:HO'OMAU AUTISM SERVICES LLC
Entity type:Organization
Organization Name:HO'OMAU AUTISM SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMS
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:808-647-6242
Mailing Address - Street 1:1101 KUKULU ST UNIT 71
Mailing Address - Street 2:
Mailing Address - City:KAPOLEI
Mailing Address - State:HI
Mailing Address - Zip Code:96707-4537
Mailing Address - Country:US
Mailing Address - Phone:630-546-3049
Mailing Address - Fax:
Practice Address - Street 1:1101 KUKULU ST UNIT 71
Practice Address - Street 2:
Practice Address - City:KAPOLEI
Practice Address - State:HI
Practice Address - Zip Code:96707-4537
Practice Address - Country:US
Practice Address - Phone:630-546-3049
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-19
Last Update Date:2024-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Multi-Specialty