Organization
KOKUA CO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIANA SEVERINE (CLINICAL DIRECTOR)
(562) 618-2319
Entity
Organization
Contact information
Practice address
5401 W 9TH ST, GREELEY, CO 80634-4431
(877) 302-5022
Mailing address
5401 W 9TH ST, GREELEY, CO 80634-4431
(877) 302-5022
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
—
—
3245S0500X
Children's Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
10/23/2018
Last updated
10/23/2018
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