Healthcare Provider Details

I. General information

NPI: 1699809772
Provider Name (Legal Business Name): NEW HORIZONS CMHC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1469 NW 36TH ST
MIAMI FL
33142-5557
US

IV. Provider business mailing address

20125 NE 3RD CT APT 6
MIAMI FL
33179-2965
US

V. Phone/Fax

Practice location:
  • Phone: 305-635-7444
  • Fax: 305-636-1711
Mailing address:
  • Phone: 305-652-5906
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code305R00000X
TaxonomyPreferred Provider Organization
License Number
License Number StateFL

VIII. Authorized Official

Name: MS. CONSUELLA DENISE ALLEN
Title or Position: CASE MANAGER
Credential: M.S.
Phone: 305-610-7987