Healthcare Provider Details

I. General information

NPI: 1255598769
Provider Name (Legal Business Name): NEW HORIZON COMPREHENSIVE YOUTH AND FAMILY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2008
Last Update Date: 05/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2420 RELIANCE AVE
APEX NC
27539-7048
US

IV. Provider business mailing address

9901 LINN STATION RD
LOUISVILLE KY
40223-3808
US

V. Phone/Fax

Practice location:
  • Phone: 919-387-1011
  • Fax: 919-387-1130
Mailing address:
  • Phone: 800-866-0860
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code253J00000X
TaxonomyFoster Care Agency
License Number
License Number StateNC

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DEENA OMBRES
Title or Position: PRIVACY OFFICER
Credential:
Phone: 502-394-3287