Provider Demographics
NPI:1720138894
Name:KOKUA HEALING ARTS OF NAPLES, INC
Entity Type:Organization
Organization Name:KOKUA HEALING ARTS OF NAPLES, INC
Other - Org Name:COMMUNITY HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AMBER
Authorized Official - Middle Name:J
Authorized Official - Last Name:ANDEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-213-0199
Mailing Address - Street 1:8813 TAMIAMI TRL E
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34113-3347
Mailing Address - Country:US
Mailing Address - Phone:239-213-0199
Mailing Address - Fax:239-649-7918
Practice Address - Street 1:8813 TAMIAMI TRL E
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34113-3347
Practice Address - Country:US
Practice Address - Phone:239-213-0199
Practice Address - Fax:239-649-7918
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-11
Last Update Date:2012-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL30211198251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1720138894OtherHOME HEALTH