Provider Demographics
NPI:1053676908
Name:NEW HORIZONS TREATMENT CENTER
Entity Type:Organization
Organization Name:NEW HORIZONS TREATMENT CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:LUCIOUS
Authorized Official - Middle Name:ERNEST
Authorized Official - Last Name:HAILEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-628-4636
Mailing Address - Street 1:547 N FAYETTEVILLE ST
Mailing Address - Street 2:
Mailing Address - City:ASHEBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27203-4725
Mailing Address - Country:US
Mailing Address - Phone:336-628-4636
Mailing Address - Fax:
Practice Address - Street 1:547 N FAYETTEVILLE ST
Practice Address - Street 2:
Practice Address - City:ASHEBORO
Practice Address - State:NC
Practice Address - Zip Code:27203-4725
Practice Address - Country:US
Practice Address - Phone:336-628-4636
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-06
Last Update Date:2016-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL-076-110251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health