MEDICARE: HOMES FOR LIFE FOUNDATION

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	251B00000X	Case Management Agency

General Provider Information

NPI Number	:	1033248133
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOMES FOR LIFE FOUNDATION

Provider Business Mailing Address
First Line	:	8939 S SEPULVEDA BLVD
Second Line	:	SUITE 460
City	:	LOS ANGELES
State	:	CA
Zip	:	90045-3631
Country	:	US
Telephone Number	:	310-337-7417
Fax Number	:	310-337-7413

Provider Business Practice Location Address
First Line	:	506 E FAIRVIEW AVE
Second Line	:	UNIT A
City	:	SAN GABRIEL
State	:	CA
Zip	:	91776-3039
Country	:	US
Telephone Number	:	310-337-7417
Fax Number	:	310-337-7413

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	CAROL M LIESS
Credential	:
Telephone Number	:	310-337-7417

Provider Enumeration Date	:	03/05/2007
Last Update Date	:	04/15/2026

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Directions to “HOMES FOR LIFE FOUNDATION ” Practice Location

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