Provider Demographics
NPI:1154439958
Name:NEW HORIZONS OF THE TREASURE COAST INC
Entity Type:Organization
Organization Name:NEW HORIZONS OF THE TREASURE COAST INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:WIMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:772-468-5600
Mailing Address - Street 1:4500 WEST MIDWAY ROAD
Mailing Address - Street 2:
Mailing Address - City:FT. PIERCE
Mailing Address - State:FL
Mailing Address - Zip Code:34981-4823
Mailing Address - Country:US
Mailing Address - Phone:772-468-5600
Mailing Address - Fax:772-468-5606
Practice Address - Street 1:4500 W. MIDWAY ROAD
Practice Address - Street 2:
Practice Address - City:FT. PIERCE
Practice Address - State:FL
Practice Address - Zip Code:34981-4823
Practice Address - Country:US
Practice Address - Phone:772-468-5600
Practice Address - Fax:772-468-5606
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-29
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL208D00000X, 363A00000X
251B00000X, 251S00000X, 261QC1500X, 282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No251B00000XAgenciesCase ManagementGroup - Multi-Specialty
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity HealthGroup - Multi-Specialty
No282N00000XHospitalsGeneral Acute Care HospitalGroup - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL195893OtherAMERIGROUP
FL00707OtherBLUE CROSS OF FL
FLE16OtherBLUE CROSS OF FLORIDA
NI191OtherHEALTHEASE
FL060316300Medicaid
157081OtherMANAGED HEALTH NETWORK
FL195893OtherAMERIGROUP