Organization
KOINONIA FOSTER HOMES, INC
Active
Other names
Koinonia Treatment Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
JARED RADDIGAN (ACCOUNTING DIRECTOR)
(916) 577-7982
Entity
Organization
Contact information
Practice address
5980 WEBB STREET, LOOMIS, CA 95650
(916) 652-0171
Mailing address
PO BOX 1403, LOOMIS, CA 95650-1403
(916) 652-0171
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
C313101
CA
Other
Enumeration date
06/12/2007
Last updated
11/03/2025
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