Provider Demographics
NPI:1346977022
Name:NEW HORIZONS PSYCHIATRIC SERVICES MATHISEN PLLC
Entity Type:Organization
Organization Name:NEW HORIZONS PSYCHIATRIC SERVICES MATHISEN PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MATHISEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-545-0229
Mailing Address - Street 1:7361 W CHARLESTON BLVD STE 130
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-1576
Mailing Address - Country:US
Mailing Address - Phone:702-545-0229
Mailing Address - Fax:
Practice Address - Street 1:7361 W CHARLESTON BLVD STE 130
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-1576
Practice Address - Country:US
Practice Address - Phone:702-545-0229
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-03
Last Update Date:2022-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty