MEDICARE: NEW HORIZONS IN AUTISM, 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
1	320600000X	Intellectual and/or Developmental Disabilities Residential Treatment Facility
2	320900000X	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility

General Provider Information

NPI Number	:	1609405661
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEW HORIZONS IN AUTISM, INC.

Provider Business Mailing Address
First Line	:	906 RTE 33
Second Line	:
City	:	FREEHOLD
State	:	NJ
Zip	:	07728-8435
Country	:	US
Telephone Number	:	732-918-0850
Fax Number	:

Provider Business Practice Location Address
First Line	:	718 VIVIAN DR
Second Line	:
City	:	TOMS RIVER
State	:	NJ
Zip	:	08753-5474
Country	:	US
Telephone Number	:	732-918-0850
Fax Number	:

Authorized Official
Title or Position	:	ASSOC. DIR. OUTREACH & DEVELOPMENT
Name	:	SIMONE WATERS
Credential	:
Telephone Number	:	732-918-0850

Provider Enumeration Date	:	04/02/2020
Last Update Date	:	04/02/2020

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