Healthcare Provider Details

I. General information

NPI: 1245096551
Provider Name (Legal Business Name): NEW LIFE AHEAD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/23/2024
Last Update Date: 12/16/2024
Certification Date: 12/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5130 MAGNOLIA AVE
RIVERSIDE CA
92506-1246
US

IV. Provider business mailing address

5130 MAGNOLIA AVE
RIVERSIDE CA
92506-1246
US

V. Phone/Fax

Practice location:
  • Phone: 562-355-8060
  • Fax:
Mailing address:
  • Phone: 562-355-8060
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: JULIO BONILLA
Title or Position: CEO
Credential:
Phone: 562-355-8060