Healthcare Provider Details

I. General information

NPI: 1770743130
Provider Name (Legal Business Name): NEW HORIZONS RECOVERY CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2008
Last Update Date: 06/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

705 DOUGLAS ST STE 315
SIOUX CITY IA
51101-1044
US

IV. Provider business mailing address

705 DOUGLAS ST STE 315
SIOUX CITY IA
51101-1044
US

V. Phone/Fax

Practice location:
  • Phone: 712-274-8071
  • Fax: 712-202-0457
Mailing address:
  • Phone: 712-274-8071
  • Fax: 712-202-0457

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code305R00000X
TaxonomyPreferred Provider Organization
License Number1218
License Number StateIA

VIII. Authorized Official

Name: MS. SALLY R STURGES
Title or Position: DIRECTOR CEO
Credential: BA CADC
Phone: 712-274-8071