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NPI Code Detail

MEDICARE: BRAND NEW HORIZON INC

MEDICARE: BRAND NEW HORIZON INC
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
1251S00000XCommunity/Behavioral Health Agency

General Provider Information

NPI Number : 1548681943
Entity Type Code : Organization
Provider Name (Legal Business Name) : BRAND NEW HORIZON INC
Provider Business Mailing Address
First Line : 4029 BONITA DESERT CT
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89032-3472
Country : US
Telephone Number : 702-580-5991
Fax Number :
Provider Business Practice Location Address
First Line : 4029 BONITA DESERT CT
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89032-3472
Country : US
Telephone Number : 702-580-5991
Fax Number :
Authorized Official
Title or Position : CEO
Name : THERESA DAVIS
Credential :
Telephone Number : 702-580-5991
Provider Enumeration Date : 01/02/2014
Last Update Date : 01/02/2014

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Directions to “BRAND NEW HORIZON INC ” Practice Location

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