KOINONIA FOSTER HOMES, INC. (NPI# 1831506534) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831506534 |
| Entity Type | Organization |
| Organization Name | KOINONIA FOSTER HOMES, INC. |
| Other Organization Name | KOINONIA FAMILY SERVICES |
| Practice Address |
4232 Big Cloud Way Antelope CA 95843-2406 |
| Mailing Address |
Po Box 1403 Loomis CA 95650-1403 |
| Practice Telephone | 9166520171 |
| Mailing Telephone | 9166522749 |
| Enumeration Date | 2014-07-15 |
| Last Update Date | 2020-01-21 |
| Authorized Official Name | JESSICA MARGUERITE MILLER (HEAD OF SERVICE) |
| Authorized Official Telephone | 9166525814 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | 80129 | CA | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| Koinonia Family Services | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902436744 | Koinonia Foster Homes, Inc. | Community/Behavioral Health | 1881 Business Center Dr Ste 10, San Bernardino, CA 92408-3465 | 2020-01-21 |
| 1437617784 | Koinonia Foster Homes, Inc. | Foster Care Agency | 6331 King Rd, Loomis, CA 95650-8801 | 2019-03-06 |
| 1942768221 | Koinonia Foster Homes, Inc. | Foster Care Agency | 8200 King Rd, Loomis, CA 95650-8813 | 2019-03-06 |
| 1396203675 | Koinonia Foster Homes, Inc. | Foster Care Agency | 5440 Paragon St, Rocklin, CA 95677-2217 | 2019-03-06 |
| 1477011740 | Koinonia Foster Homes, Inc. | Foster Care Agency | 3880 Oak Tree Ln, Loomis, CA 95650-9316 | 2019-03-06 |
| 1568920874 | Koinonia Foster Homes, Inc. | Foster Care Agency | 12344 Incline Dr, Auburn, CA 95603-3512 | 2019-03-05 |
| 1881170827 | Koinonia Foster Homes, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 7046 Beech Ave, Orangevale, CA 95662-2656 | 2018-07-12 |
| 1629570932 | Koinonia Foster Homes, Inc. | Community/Behavioral Health | 5465 Aguilar Rd, Rocklin, CA 95677-3302 | 2018-03-02 |
| 1487964839 | Koinonia Foster Homes, Inc. | Community/Behavioral Health | 1355 Airmotive Way, Reno, NV 89502-3218 | 2010-10-19 |
| 1770079824 | Koinonia Foster Homes, Inc. | Clinic/Center | 3725 Taylor Rd, Loomis, CA 95650-9283 | 2018-07-02 |
| Street Address |
4232 BIG CLOUD WAY |
| City | ANTELOPE |
| State | CA |
| Zip Code | 95843-2406 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881196350 | Attayla Marnyce Bell | Behavior Technician | 8438 Cedar Hill Ct, Antelope, CA 95843 | 2018-03-01 |
| 1699297259 | Alexej Iovita | Nursing Home Administrator | 4136 Singing Tree Way, Antelope, CA 95843 | 2017-07-14 |
| 1447386362 | Rescare California, Inc. | Intermediate Care Facility, Mentally Retarded | 8141 Chimango Way, Antelope, CA 95843 | 2007-02-26 |
| 1144373838 | Cynthia Louise Simpson | Dental Hygienist | 8124 Sheehan Way, Antelope, CA 95843 | 2007-01-18 |
| 1750471140 | Dental Corporation of Ghazal Buehler Rodgers | Dentist | 8008 Walerga Rd, Ste. 100, Antelope, CA 95843 | 2006-10-13 |
| 1235245168 | Vimal Amral Dulabh | Dentist | 3535 Elverta Rd, Suite E, Antelope, CA 95843 | 2006-08-22 |
| 1073987269 | Rex Anthony Gamoke | Pharmacist | 4331 Antelope Rd, Antelope, CA 95843 | 2015-11-25 |
| 1134302524 | Firstsight Vision Services, Inc. | Optometrist | 5821 Antelope North Rd, Antelope, CA 95843 | 2007-12-10 |
| 1386116630 | Juliya Sitaruk | Behavior Technician | 3015 Scotland Dr, Antelope, CA 95843-1928 | 2018-12-27 |
| 1861672057 | Firstsight Vision Services, Inc. | Optometrist | 7901 Watt Ave, Antelope, CA 95843-2000 | 2007-11-06 |
| Find all providers in zip 95843 | ||||
| Taxonomy Code | 320800000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment Facility, Mental Illness |
| A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |
| Notes: [7/1/2003: new] |
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| 1730780313 | Orchid Court, Inc. | Community Based Residential Treatment Facility, Mental Illness | 307 S Arrowhead Avenue, San Bernardino, CA 92408-1325 | 2020-11-02 |
| 1477151199 | Inspiring Pathways, Inc. | Community Based Residential Treatment Facility, Mental Illness | 1798 Bryman St, Hanford, CA 93230-7144 | 2020-10-14 |
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| 1326645904 | New Passages Group Home, Inc. | Community Based Residential Treatment Facility, Mental Illness | 5675 E Ashlan Ave, Fresno, CA 93727-7220 | 2020-10-06 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.