Provider Demographics
NPI:1417738139
Name:A NEW WAY HOME
Entity Type:Organization
Organization Name:A NEW WAY HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO AND PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ESTID
Authorized Official - Middle Name:
Authorized Official - Last Name:DADO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-419-6470
Mailing Address - Street 1:1739 N VERDE AVE
Mailing Address - Street 2:
Mailing Address - City:RIALTO
Mailing Address - State:CA
Mailing Address - Zip Code:92376-2750
Mailing Address - Country:US
Mailing Address - Phone:626-419-6470
Mailing Address - Fax:
Practice Address - Street 1:2999 KENDALL DR.
Practice Address - Street 2:STE 204 PMB 6004
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92407
Practice Address - Country:US
Practice Address - Phone:800-259-6061
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-09
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty