Healthcare Provider Details

I. General information

NPI: 1205749934
Provider Name (Legal Business Name): NEW HORIZONS INTEGRATED CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2026
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7516 HIGHWAY 493
MERIDIAN MS
39305-8361
US

IV. Provider business mailing address

PO BOX 202
MERIDIAN MS
39302-0202
US

V. Phone/Fax

Practice location:
  • Phone: 601-678-7153
  • Fax:
Mailing address:
  • Phone: 601-678-7153
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: TERRI BOURRAGE
Title or Position: FOUNDER & EXECUTIVE DIRECTOR
Credential:
Phone: 601-678-7153