MEDICARE: NEW HORIZONS TREATMENT CENTER

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	251S00000X	Community/Behavioral Health Agency	MHL-076-110	NC

General Provider Information

NPI Number	:	1053676908
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEW HORIZONS TREATMENT CENTER

Provider Business Mailing Address
First Line	:	547 N FAYETTEVILLE ST
Second Line	:
City	:	ASHEBORO
State	:	NC
Zip	:	27203-4725
Country	:	US
Telephone Number	:	336-628-4636
Fax Number	:

Provider Business Practice Location Address
First Line	:	547 N FAYETTEVILLE ST
Second Line	:
City	:	ASHEBORO
State	:	NC
Zip	:	27203-4725
Country	:	US
Telephone Number	:	336-628-4636
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MR. LUCIOUS ERNEST HAILEY
Credential	:
Telephone Number	:	336-628-4636

Provider Enumeration Date	:	07/06/2012
Last Update Date	:	03/08/2016

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