MEDICARE: NEW HOME FOR ME, 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	310400000X	Assisted Living Facility	197608840	CA

General Provider Information

NPI Number	:	1558717934
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEW HOME FOR ME, INC

Provider Business Mailing Address
First Line	:	1015 S ORANGE GROVE AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90019-6510
Country	:	US
Telephone Number	:	323-933-8271
Fax Number	:	323-933-5889

Provider Business Practice Location Address
First Line	:	1015 S ORANGE GROVE AVE
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90019-6510
Country	:	US
Telephone Number	:	323-933-8271
Fax Number	:	323-933-5889

Authorized Official
Title or Position	:	LICENSEE/OWNER
Name	:	ANNIE P JIANG
Credential	:
Telephone Number	:	626-679-6020

Provider Enumeration Date	:	05/04/2016
Last Update Date	:	05/04/2016

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Directions to “NEW HOME FOR ME, INC ” Practice Location

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