Healthcare Provider Details

I. General information

NPI: 1538356977
Provider Name (Legal Business Name): NEW HORIZONS NORTH, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2007
Last Update Date: 10/01/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 W BAYFIELD ST
WASHBURN WI
54891-1131
US

IV. Provider business mailing address

514 MAIN ST W
ASHLAND WI
54806-1512
US

V. Phone/Fax

Practice location:
  • Phone: 715-373-5505
  • Fax: 715-373-2203
Mailing address:
  • Phone: 715-682-7171
  • Fax: 715-682-7176

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number1061-800
License Number StateWI

VIII. Authorized Official

Name: MS. JENNIFER FELTY
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 715-682-7171