MEDICARE: NEW HORIZONS CINCINNATI 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	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)
2	324500000X	Substance Abuse Rehabilitation Facility

General Provider Information

NPI Number	:	1477277416
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEW HORIZONS CINCINNATI LLC

Provider Business Mailing Address
First Line	:	9145 GOVERNORS WAY
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45249-2037
Country	:	US
Telephone Number	:	513-905-0255
Fax Number	:

Provider Business Practice Location Address
First Line	:	9145 GOVERNORS WAY
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45249-2037
Country	:	US
Telephone Number	:	513-905-0255
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	YISROEL NUSSBAUM
Credential	:
Telephone Number	:	513-905-0255

Provider Enumeration Date	:	10/03/2022
Last Update Date	:	11/21/2024

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