Provider Demographics
NPI:1942059183
Name:MAUI RECOVERY SERVICES LLC
Entity type:Organization
Organization Name:MAUI RECOVERY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:AMORY
Authorized Official - Middle Name:
Authorized Official - Last Name:MOWREY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-864-9131
Mailing Address - Street 1:120 PUNAKEA LOOP
Mailing Address - Street 2:
Mailing Address - City:LAHAINA
Mailing Address - State:HI
Mailing Address - Zip Code:96761-5733
Mailing Address - Country:US
Mailing Address - Phone:415-864-9131
Mailing Address - Fax:
Practice Address - Street 1:120 PUNAKEA LOOP
Practice Address - Street 2:
Practice Address - City:LAHAINA
Practice Address - State:HI
Practice Address - Zip Code:96761-5733
Practice Address - Country:US
Practice Address - Phone:415-864-9131
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-17
Last Update Date:2024-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness