| Kokwaa | |
|
6144 Hillside Ave Ste 11 Indianapolis IN 46220-2474 | |
| (502) 705-3906 | |
| Not Available |
| Full Name | Kokwaa |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 6144 Hillside Ave Ste 11, Indianapolis, Indiana |
| Authorized Official Name and Position | Angelica Marilyn Ronke (CLINICAL MANAGER) |
| Authorized Official Contact | 5027053906 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kokwaa 6144 Hillside Ave Ste 11 Indianapolis IN 46220-2474 Ph: (502) 705-3906 | Kokwaa 6144 Hillside Ave Ste 11 Indianapolis IN 46220-2474 Ph: (502) 705-3906 |
| NPI Number | 1114702487 |
|---|---|
| Provider Enumeration Date | 08/25/2023 |
| Last Update Date | 08/25/2023 |
| Certification Date | 08/25/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114702487 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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