Provider Demographics
NPI:1104025857
Name:NEW HORIZONS
Entity Type:Organization
Organization Name:NEW HORIZONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACCOUNTING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PATSY
Authorized Official - Middle Name:D
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-671-8131
Mailing Address - Street 1:2406 FERRAND STREET
Mailing Address - Street 2:SUITE 18
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71201
Mailing Address - Country:US
Mailing Address - Phone:318-323-1661
Mailing Address - Fax:318-323-5445
Practice Address - Street 1:2406 FERRARD ATREET
Practice Address - Street 2:SUITE 18
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201
Practice Address - Country:US
Practice Address - Phone:318-323-1661
Practice Address - Fax:318-323-5445
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-13
Last Update Date:2007-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPCA10803305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1196631Medicaid