1487964839 NPI number — KOINONIA FOSTER HOMES, INC.

Table of content: DR. KELLEY CHRISTINE SANDERS PH.D., CAP (NPI 1366788606)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487964839 NPI number — KOINONIA FOSTER HOMES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
KOINONIA FOSTER HOMES, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1487964839
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/27/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1355 AIRMOTIVE WAY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RENO
Provider Business Mailing Address State Name:
NV
Provider Business Mailing Address Postal Code:
89502-3218
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
775-826-1113
Provider Business Mailing Address Fax Number:
775-826-0248

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1355 AIRMOTIVE WAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
RENO
Provider Business Practice Location Address State Name:
NV
Provider Business Practice Location Address Postal Code:
89502-3218
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
775-826-1113
Provider Business Practice Location Address Fax Number:
775-826-0248
Provider Enumeration Date:
10/19/2010

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
ARGUELLO
Authorized Official First Name:
SANDRA
Authorized Official Middle Name:
Authorized Official Title or Position:
ASSOCIATE EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
775-826-1113

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)