| Organization Name: | KOINONIA FOSTER HOMES, INC |
| NPI Number: | 1770787020 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | WILLIAM RYLAND (ADMINISTRATOR) |
| Mailing Address: | 5980 Webb Street Loomis |
| State: | CA US |
| Postal Code: | 95650 |
| Phone Number: | 9166520171 |
| Fax Number: | |
| NPI Enumeration Date: | 06/12/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR0405X |
| License Number: | C313101 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Rehabilitation, Substance Use Disorder |
| Taxonomy Definition: | |