Healthcare Provider Details

I. General information

NPI: 1730851015
Provider Name (Legal Business Name): NEW HORIZONS PROFESSIONAL SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2021
Last Update Date: 03/22/2022
Certification Date: 03/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

824 BLAZINGWOOD DR
GREENSBORO NC
27406-8227
US

IV. Provider business mailing address

4201 TRISTON DR
GREENSBORO NC
27407-7547
US

V. Phone/Fax

Practice location:
  • Phone: 336-285-8002
  • Fax:
Mailing address:
  • Phone: 336-689-0374
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: BRYAN LAMONT TELFAIR
Title or Position: OWNER/DIRECTOR
Credential:
Phone: 336-689-0374