Provider Demographics
NPI:1801378112
Name:KOKORO HEALTH & WELLNESS INC.
Entity Type:Organization
Organization Name:KOKORO HEALTH & WELLNESS INC.
Other - Org Name:KOKORO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:ADRIANE
Authorized Official - Middle Name:
Authorized Official - Last Name:ALEXANDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-463-3353
Mailing Address - Street 1:14850 MONTFORT DR STE 181
Mailing Address - Street 2:LB 11
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75254-1450
Mailing Address - Country:US
Mailing Address - Phone:469-431-5656
Mailing Address - Fax:214-446-6010
Practice Address - Street 1:14850 MONTFORT DR STE 181
Practice Address - Street 2:LB 11
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75254-1450
Practice Address - Country:US
Practice Address - Phone:469-431-5656
Practice Address - Fax:214-446-6010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-04
Last Update Date:2020-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No251E00000XAgenciesHome Health
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-SpecialtyGroup - Multi-Specialty
No261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitationGroup - Multi-Specialty