MEDICARE: HARMONY HOUSE RESIDENTIAL CARE LLC

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

General Provider Information

NPI Number	:	1881475812
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HARMONY HOUSE RESIDENTIAL CARE LLC

Provider Business Mailing Address
First Line	:	636 E 8TH ST
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90813-4606
Country	:	US
Telephone Number	:	323-598-7955
Fax Number	:

Provider Business Practice Location Address
First Line	:	701 PINE AVE STE 403
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90813-4321
Country	:	US
Telephone Number	:	323-598-7955
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MS. CATHERINE MICHELLE GILL
Credential	:
Telephone Number	:	323-598-7955

Provider Enumeration Date	:	10/05/2023
Last Update Date	:	10/05/2023

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