Provider Demographics
NPI:1235609793
Name:NEW HORIZON LODGE,INC.
Entity Type:Organization
Organization Name:NEW HORIZON LODGE,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-588-3845
Mailing Address - Street 1:8541 CERRITOS AVE
Mailing Address - Street 2:
Mailing Address - City:STANTON
Mailing Address - State:CA
Mailing Address - Zip Code:90680-1838
Mailing Address - Country:US
Mailing Address - Phone:714-821-5780
Mailing Address - Fax:714-821-5783
Practice Address - Street 1:8541 CERRITOS AVE
Practice Address - Street 2:
Practice Address - City:STANTON
Practice Address - State:CA
Practice Address - Zip Code:90680-1838
Practice Address - Country:US
Practice Address - Phone:714-821-5780
Practice Address - Fax:714-821-5783
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-27
Last Update Date:2018-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility