Provider Demographics
NPI:1851834055
Name:KOINONIA FOSTER HOMES INC
Entity Type:Organization
Organization Name:KOINONIA FOSTER HOMES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACCOUNTING DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEENA
Authorized Official - Middle Name:
Authorized Official - Last Name:SPANN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-652-5802
Mailing Address - Street 1:PO BOX 1403
Mailing Address - Street 2:
Mailing Address - City:LOOMIS
Mailing Address - State:CA
Mailing Address - Zip Code:95650-1403
Mailing Address - Country:US
Mailing Address - Phone:916-652-5802
Mailing Address - Fax:
Practice Address - Street 1:4600 AMERICAN AVENUE, EAST
Practice Address - Street 2:STE. 101
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309
Practice Address - Country:US
Practice Address - Phone:661-833-4483
Practice Address - Fax:661-833-4481
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-21
Last Update Date:2016-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health