MEDICARE: HARMONY 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	315P00000X	Intellectual Disabilities Intermediate Care Facility		CA

General Provider Information

NPI Number	:	1083081954
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HARMONY HOMES INC.

Provider Business Mailing Address
First Line	:	1034 W MESA AVE
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93711-2001
Country	:	US
Telephone Number	:	559-449-1605
Fax Number	:	559-449-1552

Provider Business Practice Location Address
First Line	:	6429 N ELLENDALE AVE
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93722-2410
Country	:	US
Telephone Number	:	559-271-9803
Fax Number	:	559-449-1552

Authorized Official
Title or Position	:	QIDP
Name	:	JEREMY DAVID WINANS
Credential	:
Telephone Number	:	559-449-1605

Provider Enumeration Date	:	08/27/2015
Last Update Date	:	08/27/2015

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