Provider Demographics
NPI:1518042407
Name:NEW LIFE VENTURE CORP
Entity Type:Organization
Organization Name:NEW LIFE VENTURE CORP
Other - Org Name:CARDINAL HOME HEALTH CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ARMAND
Authorized Official - Middle Name:AGUILAR
Authorized Official - Last Name:ALMARIO
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:909-740-5128
Mailing Address - Street 1:226 W E ST
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:CA
Mailing Address - Zip Code:91762-3420
Mailing Address - Country:US
Mailing Address - Phone:909-395-8333
Mailing Address - Fax:909-395-8337
Practice Address - Street 1:226 W E ST
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:CA
Practice Address - Zip Code:91762
Practice Address - Country:US
Practice Address - Phone:909-395-8333
Practice Address - Fax:909-395-8337
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-26
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA550000533251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA059021Medicare Oscar/Certification