MEDICARE: NEW HORIZON LIVING LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	101YA0400X	Addiction (Substance Use Disorder) Counselor
2	103TA0400X	Addiction (Substance Use Disorder) Psychologist
3	104100000X	Social Worker
4	146L00000X	Paramedic
5	163WA0400X	Addiction (Substance Use Disorder) Registered Nurse
6	164W00000X	Licensed Practical Nurse
7	171M00000X	Case Manager/Care Coordinator
8	207RA0401X	Addiction Medicine (Internal Medicine) Physician
9	251B00000X	Case Management Agency
10	2084A0401X	Addiction Medicine (Psychiatry & Neurology) Physician
11	227800000X	Certified Respiratory Therapist
12	251S00000X	Community/Behavioral Health Agency
13	310400000X	Assisted Living Facility
14	374U00000X	Home Health Aide
15	324500000X	Substance Abuse Rehabilitation Facility

General Provider Information

NPI Number	:	1447105499
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEW HORIZON LIVING LLC

Provider Business Mailing Address
First Line	:	11000 W MCNICHOLS RD STE 323
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48221-2393
Country	:	US
Telephone Number	:	586-265-4675
Fax Number	:

Provider Business Practice Location Address
First Line	:	15087 WARD ST
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48227-4074
Country	:	US
Telephone Number	:	586-265-4675
Fax Number	:

Authorized Official
Title or Position	:	OWNER/MANAGER
Name	:	MR. DEIONTAE NICHOLAS
Credential	:
Telephone Number	:	586-265-4675

Provider Enumeration Date	:	03/03/2026
Last Update Date	:	03/03/2026

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