Organization · NPI-2
Bridgette Grant Lcsw LLC
Clinic/Center, Adult Mental Health · Lahaina, HI
NPI number1366901472
StatusActive
Last updated in NPPESMar 18, 2019
Details
- NPI
- 1366901472
- Entity type
- Organization (NPI-2)
- Legal business name
- Bridgette Grant Lcsw LLC
- Organization subpart
- No
- Enumeration date
- Mar 18, 2019
- Last updated
- Mar 18, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QM0850X | Clinic/Center, Adult Mental Health | – | – | Yes |
Practice location
4435 Lower Honoapiillani Rd142
Lahaina, HI 96761
Phone 267-975-8308
Mailing address
4435 Lower Honoapillani Rd142
Lahaina, HI 96761
Phone 267-975-8308
Authorized official
Bridgette Marie Grant
Lcsw
2679758308
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