| Koinonia Foster Homes, Inc. | |
|
3880 Oak Tree Ln Loomis CA 95650-9316 | |
| (916) 652-0171 | |
| Not Available |
| Full Name | Koinonia Foster Homes, Inc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 3880 Oak Tree Ln, Loomis, California |
| Authorized Official Name and Position | Bill Ryland (DIRECTOR) |
| Authorized Official Contact | 9166520171 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Koinonia Foster Homes, Inc. Po Box 1403 Loomis CA 95650-1403 Ph: (916) 652-0171 | Koinonia Foster Homes, Inc. 3880 Oak Tree Ln Loomis CA 95650-9316 Ph: (916) 652-0171 |
| NPI Number | 1477011740 |
|---|---|
| Provider Enumeration Date | 03/06/2019 |
| Last Update Date | 03/06/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477011740 | NPI | - | NPPES |
| 317000017 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| 253J00000X | Foster Care Agency | (* (Not Available)) | Secondary |
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