OrganizationCollaborative Health PromotionClinic/CenterAmbulatory Health Care FacilitiesPractice Address1221 Kapiolani Blvd, Penthouse 50 & 60, Honlulu, HI 96814(808) 260-9893PECOS EnrollmentBased on the most recent information from CMS, provider Collaborative Health Promotion does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1568095586Provider TypeOrganizationFull NameCollaborative Health PromotionSubpartNoEnumeration Date2/18/2020Last Updated2/19/2020Contact InformationPractice LocationPractice Address1221 Kapiolani Blvd, Penthouse 50 & 60, Honlulu, HI 96814Phone(808) 260-9893FaxUnlisted FaxMailing LocationMailing Address1221 Kapiolani Blvd, Penthouse 50 & 60, Honlulu, HI 96814PhoneUnlisted PhoneFaxUnlisted FaxAuthorized OfficialNameBaez, Vilmarie (Clinical Psychologist)Phone(954) 257-4247Provider TaxonomiesCodeDescriptionLicenseCode261QM0850XPrimaryDescriptionClinic/CenterAmbulatory Health Care FacilitiesLicenseUnlisted Issuer