Organization
KOKUA WELLNESS INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL BRADSHAW CATC I (CEO)
(818) 723-9403
Entity
Organization
Contact information
Practice address
1219 VIA CIELITO, VENTURA, CA 93003-1225
(818) 723-9403
Mailing address
2861 LOS ROBLES RD, THOUSAND OAKS, CA 91362-3359
(760) 590-5135
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
05/29/2023
Last updated
05/29/2023
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