Provider Demographics
NPI:1104370550
Name:NEW WORLD YOUTH CENTER
Entity Type:Organization
Organization Name:NEW WORLD YOUTH CENTER
Other - Org Name:NEW WORLD BEHAVIORAL HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/DIRECT SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:SHEILA
Authorized Official - Middle Name:
Authorized Official - Last Name:LOUISON
Authorized Official - Suffix:
Authorized Official - Credentials:QMHA
Authorized Official - Phone:310-384-3312
Mailing Address - Street 1:68 BELLE SOLEIL AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89123-3412
Mailing Address - Country:US
Mailing Address - Phone:310-384-3312
Mailing Address - Fax:
Practice Address - Street 1:68 BELLE SOLEIL AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89123-3412
Practice Address - Country:US
Practice Address - Phone:310-384-3312
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-14
Last Update Date:2016-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health