MEDICARE: BAILEY CARE HOMES, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	320600000X	Intellectual and/or Developmental Disabilities Residential Treatment Facility		CA

General Provider Information

NPI Number	:	1538385729
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BAILEY CARE HOMES, INC.

Provider Business Mailing Address
First Line	:	23120 ALICIA PKWY STE 200
Second Line	:
City	:	MISSION VIEJO
State	:	CA
Zip	:	92692-1212
Country	:	US
Telephone Number	:	949-439-0880
Fax Number	:

Provider Business Practice Location Address
First Line	:	9811 S DENKER AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90047-3965
Country	:	US
Telephone Number	:	323-754-7874
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	SHAWN BAILEY
Credential	:
Telephone Number	:	310-293-8722

Provider Enumeration Date	:	04/17/2007
Last Update Date	:	11/29/2007

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