| Koinonia Foster Homes, Inc. | |
|
41689 Enterprise Cir N Ste 120 Temecula CA 92590-5630 | |
| (951) 587-4165 | |
| (951) 587-4297 |
| Full Name | Koinonia Foster Homes, Inc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 41689 Enterprise Cir N Ste 120, Temecula, California |
| Authorized Official Name and Position | Tiffany Danielle Sickler (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 9166525802 |
| 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) 652-5802 | Koinonia Foster Homes, Inc. 41689 Enterprise Cir N Ste 120 Temecula CA 92590-5630 Ph: (951) 587-4165 |
| NPI Number | 1467995738 |
|---|---|
| Provider Enumeration Date | 11/18/2016 |
| Last Update Date | 03/10/2023 |
| Certification Date | 03/10/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467995738 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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