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General NPI Number Information
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NPI Number | 1124102512
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Entity Type | Organization
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Legal Business Name | NEW HORIZONS GUEST HOME LLC
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Dates
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Enumeration Date | 10/24/2006
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Last Update Date | 06/24/2008
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Provider Practice Location Address
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Address Line | 3630 MORSE AVE
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City | SACRAMENTO
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State | CA
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Zip | 95821-1812
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Country | US
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Telephone | 916-482-7211
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Fax | 916-482-2069
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Provider Business Mailing Address
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Address Line | 340 ARCHES AVE
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City | EL DORADO HILLS
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State | CA
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Zip | 95762-7313
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Country | US
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Telephone | 916-939-8083
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Fax | 916-939-8086
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Authorized Official
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Title or Position | OWNER/ ADMINISTRATOR
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Name | MR. ANA MILLER
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Credential | RN, BSN
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Telephone | 916-482-7211
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number | 347001481
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License Number State | CA
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