| Kamali'i Foster Family Agency, Inc. | |
|
31772 Casino Dr Ste B Lake Elsinore CA 92530-4502 | |
| (951) 674-9400 | |
| (951) 674-9486 |
| Full Name | Kamali'i Foster Family Agency, Inc. |
|---|---|
| Speciality | Foster Care Agency |
| Location | 31772 Casino Dr Ste B, Lake Elsinore, California |
| Authorized Official Name and Position | John Eric Mortensen (CEO/PROGRAM DIRECTOR) |
| Authorized Official Contact | 9516749400 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kamali'i Foster Family Agency, Inc. 31772 Casino Dr Ste B Lake Elsinore CA 92530-4502 Ph: (951) 674-9400 | Kamali'i Foster Family Agency, Inc. 31772 Casino Dr Ste B Lake Elsinore CA 92530-4502 Ph: (951) 674-9400 |
| NPI Number | 1104382183 |
|---|---|
| Provider Enumeration Date | 02/14/2019 |
| Last Update Date | 06/24/2025 |
| Certification Date | 06/24/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104382183 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| 253J00000X | Foster Care Agency | (* (Not Available)) | Primary |
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