Provider Demographics
NPI:1316027998
Name:NHI HOME BASE SERVICE CORP.
Entity Type:Organization
Organization Name:NHI HOME BASE SERVICE CORP.
Other - Org Name:NEW HORIZON INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF OF OPERATIONS
Authorized Official - Prefix:MS
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:L
Authorized Official - Last Name:NALLS
Authorized Official - Suffix:IX
Authorized Official - Credentials:
Authorized Official - Phone:219-887-3688
Mailing Address - Street 1:4795 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:GARY
Mailing Address - State:IN
Mailing Address - Zip Code:46409-2403
Mailing Address - Country:US
Mailing Address - Phone:219-887-3688
Mailing Address - Fax:219-887-2666
Practice Address - Street 1:4795 BROADWAY
Practice Address - Street 2:
Practice Address - City:GARY
Practice Address - State:IN
Practice Address - Zip Code:46409
Practice Address - Country:US
Practice Address - Phone:219-887-3688
Practice Address - Fax:219-887-2666
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-17
Last Update Date:2018-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200110090Medicaid