MEDICARE: NEW FOUNDATION ASSISTED LIVING FACILITY

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	310400000X	Assisted Living Facility

General Provider Information

NPI Number	:	1639349855
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEW FOUNDATION ASSISTED LIVING FACILITY

Provider Business Mailing Address
First Line	:	8619 BOLD FOREST DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77088-2301
Country	:	US
Telephone Number	:	281-448-7710
Fax Number	:	281-448-7710

Provider Business Practice Location Address
First Line	:	8619 BOLD FOREST DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77088-2301
Country	:	US
Telephone Number	:	281-448-7710
Fax Number	:	281-448-7710

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MR. DONALD M WRIGHT SR.
Credential	:
Telephone Number	:	281-449-7710

Provider Enumeration Date	:	03/04/2008
Last Update Date	:	03/04/2008

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