MEDICARE: NEW HORIZONS HEALTHCARE LLC

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	251G00000X	Community Based Hospice Care Agency
2	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1437660297
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEW HORIZONS HEALTHCARE LLC

Provider Business Mailing Address
First Line	:	15102 S BRIAR CREST CT
Second Line	:
City	:	DRAPER
State	:	UT
Zip	:	84020-5538
Country	:	US
Telephone Number	:	801-856-2826
Fax Number	:

Provider Business Practice Location Address
First Line	:	1030 W BELLWOOD LN
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84123-4494
Country	:	US
Telephone Number	:	801-856-2826
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	FRANK L FULLMER
Credential	:
Telephone Number	:	801-856-2826

Provider Enumeration Date	:	10/19/2017
Last Update Date	:	10/19/2017

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