Individual
MS. KASHIRA FOSTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4810 INGERSOLL AVE, DES MOINES, IA 50312-2061
(651) 515-6580
Mailing address
PO BOX 71441, CLIVE, IA 50325-0441
(651) 515-6580
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
883412414
IA
Other
Enumeration date
09/16/2022
Last updated
09/14/2023
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