Provider Demographics
NPI:1801784830
Name:4KD FAMILY SERVICES
Entity type:Organization
Organization Name:4KD FAMILY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MANASE
Authorized Official - Middle Name:FAUVAO
Authorized Official - Last Name:FOKETI
Authorized Official - Suffix:
Authorized Official - Credentials:BA
Authorized Official - Phone:310-944-8785
Mailing Address - Street 1:5868 INGLESTON DR
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89436-5017
Mailing Address - Country:US
Mailing Address - Phone:310-944-8785
Mailing Address - Fax:
Practice Address - Street 1:5868 INGLESTON DR
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89436-5017
Practice Address - Country:US
Practice Address - Phone:310-944-8785
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-26
Last Update Date:2025-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253J00000XAgenciesFoster Care Agency