Koinonia Foster Homes, Inc. | |
5440 Paragon St Rocklin CA 95677-2217 | |
(916) 652-0171 | |
Not Available |
Full Name | Koinonia Foster Homes, Inc. |
---|---|
Speciality | Community/behavioral Health |
Location | 5440 Paragon St, Rocklin, 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. 5440 Paragon St Rocklin CA 95677-2217 Ph: (916) 652-0171 |
NPI Number | 1396203675 |
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Provider Enumeration Date | 03/06/2019 |
Last Update Date | 03/06/2019 |
Identifier | Type | State | Issuer |
---|---|---|---|
1396203675 | NPI | - | NPPES |
310311378 | 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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