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General NPI Number Information
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NPI Number | 1003231358
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Entity Type | Organization
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Legal Business Name | NEW HORIZONS MEDICAL DETOX
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Dates
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Enumeration Date | 02/24/2014
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Last Update Date | 02/27/2014
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Provider Practice Location Address
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Address Line | 7150 W 20TH AVE STE 510
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City | HIALEAH
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State | FL
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Zip | 33016-5534
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Country | US
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Telephone | 786-310-7649
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 4488
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City | FT LAUDERDALE
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State | FL
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Zip | 33338-4488
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | DAVID HOSKINS
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Credential |
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Telephone | 786-310-7649
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State | FL
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