MEDICARE: NEW HORIZONS AREA MH MR SA PROGRAM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1154315422
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEW HORIZONS AREA MH MR SA PROGRAM

Provider Business Mailing Address
First Line	:	2100 COMER AVE
Second Line	:
City	:	COLUMBUS
State	:	GA
Zip	:	31904-8725
Country	:	US
Telephone Number	:	706-596-5583
Fax Number	:	706-596-5589

Provider Business Practice Location Address
First Line	:	2100 COMER AVE
Second Line	:
City	:	COLUMBUS
State	:	GA
Zip	:	31904-8725
Country	:	US
Telephone Number	:	706-596-5583
Fax Number	:	706-596-5589

Authorized Official
Title or Position	:	REMOVE
Name	:	TARA MALONE
Credential	:
Telephone Number	:	706-596-5500

Provider Enumeration Date	:	09/01/2005
Last Update Date	:	05/19/2025

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