Provider Demographics
NPI:1073366415
Name:FOSTER GROUP INVESTMENT
Entity Type:Organization
Organization Name:FOSTER GROUP INVESTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JURO CHRIST
Authorized Official - Middle Name:E
Authorized Official - Last Name:ADEFUIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-552-7775
Mailing Address - Street 1:225 E BROADWAY STE B105A
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91205-1097
Mailing Address - Country:US
Mailing Address - Phone:562-552-7775
Mailing Address - Fax:
Practice Address - Street 1:225 E BROADWAY STE B105A
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91205-1097
Practice Address - Country:US
Practice Address - Phone:562-552-7775
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-08
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health