Provider Demographics
NPI:1023149366
Name:HOMES FOR LIFE FOUNDATION
Entity type:Organization
Organization Name:HOMES FOR LIFE FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPPORTIVE SERVICES COORDINATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:CHRISTINE
Authorized Official - Last Name:SHANER
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:310-938-3500
Mailing Address - Street 1:8939 S SEPULVEDA BLVD
Mailing Address - Street 2:SUITE 460
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90045-3631
Mailing Address - Country:US
Mailing Address - Phone:310-337-7413
Mailing Address - Fax:
Practice Address - Street 1:8939 S SEPULVEDA BLVD
Practice Address - Street 2:SUITE 460
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90045-3631
Practice Address - Country:US
Practice Address - Phone:310-337-7413
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility