Basic Information
| Provider Information | |||||||||
| NPI: | 1932485729 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | THE COMMUNICATION STATION, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 94-1014 AHAHUI PL | ||||||||
| Address2: | |||||||||
| City: | MILILANI | ||||||||
| State: | HI | ||||||||
| PostalCode: | 967892554 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8084995362 | ||||||||
| FaxNumber: | 8083792223 | ||||||||
| Practice Location | |||||||||
| Address1: | 70 S KAMEHAMEHA HWY STE 6 | ||||||||
| Address2: | |||||||||
| City: | WAHIAWA | ||||||||
| State: | HI | ||||||||
| PostalCode: | 967861856 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8084995362 | ||||||||
| FaxNumber: | 8083792223 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/25/2011 | ||||||||
| LastUpdateDate: | 08/09/2020 | ||||||||
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| AuthorizedOfficialLastName: | MAES | ||||||||
| AuthorizedOfficialFirstName: | BRIANNA | ||||||||
| AuthorizedOfficialMiddleName: | MARIE | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 8084995362 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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| AuthorizedOfficialCredential: | SLP, BCBA | ||||||||
| NPICertificationDate: | 08/09/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QH0700X | N | Ambulatory Health Care Facilities | Clinic/Center | Hearing and Speech | 103K00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Behavioral Analyst |
No ID Information.