Provider Demographics
NPI:1114225679
Name:NEW HOUSE INC
Entity Type:Organization
Organization Name:NEW HOUSE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:PAT
Authorized Official - Middle Name:
Authorized Official - Last Name:SUTAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:909-881-0390
Mailing Address - Street 1:2130 N ARROWHEAD AVE
Mailing Address - Street 2:SUITE 112
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92405-4029
Mailing Address - Country:US
Mailing Address - Phone:909-881-0390
Mailing Address - Fax:909-881-0391
Practice Address - Street 1:2130 N ARROWHEAD AVE
Practice Address - Street 2:SUITE 112
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92405-4029
Practice Address - Country:US
Practice Address - Phone:909-881-0390
Practice Address - Fax:909-881-0391
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-08
Last Update Date:2011-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA101YA0400XOtherCOUNSELOR/ADDICTION (SUBSTANCE USE DISORDER)