Provider Demographics
NPI:1376772483
Name:NEW HORIZON GENUINE CARE
Entity Type:Organization
Organization Name:NEW HORIZON GENUINE CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:LANITA
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:BA
Authorized Official - Phone:336-408-4631
Mailing Address - Street 1:4661 KELLYS TRL
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27101-2319
Mailing Address - Country:US
Mailing Address - Phone:336-408-4631
Mailing Address - Fax:
Practice Address - Street 1:4661 KELLYS TRL
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27101-2319
Practice Address - Country:US
Practice Address - Phone:336-408-4631
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-09
Last Update Date:2009-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services