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General NPI Number Information
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NPI Number | 1447458385
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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 | 07/03/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3400 JACKSON STREET SUITE A
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City | ALEXANDRIA
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State | LA
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Zip | 71301
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Country | US
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Telephone | 888-361-3596
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Fax | 318-484-3640
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Provider Business Mailing Address
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Address Line | 3400 JACKSO STREET SUITE A
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City | ALEXANDRIA
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State | LA
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Zip | 71301
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Country | US
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Telephone | 888-361-3596
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Fax | 318-484-3640
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Authorized Official
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Title or Position | EXECUTIVE DRIECTOR
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Name | 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 | PCA10802
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License Number State | LA
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