| Koinonia Foster Homes, Inc. | |
|
12344 Incline Dr Auburn CA 95603-3512 | |
| (916) 652-0171 | |
| Not Available |
| Full Name | Koinonia Foster Homes, Inc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 12344 Incline Dr, Auburn, California |
| Authorized Official Name and Position | Jared Raddigan (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 9165777982 |
| 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. 12344 Incline Dr Auburn CA 95603-3512 Ph: (916) 652-0171 |
| NPI Number | 1568920874 |
|---|---|
| Provider Enumeration Date | 03/05/2019 |
| Last Update Date | 11/03/2025 |
| Certification Date | 11/03/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568920874 | NPI | - | NPPES |
| 317005938 | 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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