MEDICARE: BLISSFUL HORIZON FOUNDATION INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	324500000X	Substance Abuse Rehabilitation Facility
2	385H00000X	Respite Care
3	251K00000X	Public Health or Welfare Agency
4	251S00000X	Community/Behavioral Health Agency
5	251V00000X	Voluntary or Charitable Agency
6	320700000X	Physical Disabilities Residential Treatment Facility
7	251B00000X	Case Management Agency
8	174200000X	Meals Provider
9	177F00000X	Lodging Provider

General Provider Information

NPI Number	:	1497623821
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BLISSFUL HORIZON FOUNDATION INC

Provider Business Mailing Address
First Line	:	38700 5TH ST W STE G
Second Line	:
City	:	PALMDALE
State	:	CA
Zip	:	93551-3996
Country	:	US
Telephone Number	:	626-818-0411
Fax Number	:

Provider Business Practice Location Address
First Line	:	1759 WINDERMERE DR
Second Line	:
City	:	LANCASTER
State	:	CA
Zip	:	93534-5319
Country	:	US
Telephone Number	:	626-818-0411
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	ELLYN HARTONO
Credential	:
Telephone Number	:	626-818-0411

Provider Enumeration Date	:	10/27/2025
Last Update Date	:	10/27/2025

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