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General NPI Number Information
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NPI Number | 1003033473
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Entity Type | Organization
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Legal Business Name | NEW HORIZONS
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Dates
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Enumeration Date | 04/19/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 9300 MANSFIELD RD SUITE 204
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City | SHREVEPORT
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State | LA
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Zip | 71118
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Country | US
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Telephone | 318-671-8131
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Fax | 318-688-7823
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Provider Business Mailing Address
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Address Line | 9300 MANSFIELD RD SUITE 204
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City | SHREVEPORT
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State | LA
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Zip | 71118
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Country | US
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Telephone | 318-671-8131
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Fax | 318-688-7823
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Authorized Official
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Title or Position | EX DIRECTOR
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Name | MRS. GALE M DEAN
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Credential |
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Telephone | 318-671-8131
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number | PCA9546
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License Number State | LA
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