Provider Demographics
NPI:1669028189
Name:NEW SEASON OF OHIO, LP
Entity Type:Organization
Organization Name:NEW SEASON OF OHIO, LP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:RODNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:407-351-7080
Mailing Address - Street 1:2500 MAITLAND CENTER PKWY STE 250
Mailing Address - Street 2:
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751-4174
Mailing Address - Country:US
Mailing Address - Phone:407-351-7080
Mailing Address - Fax:
Practice Address - Street 1:6300 BROOKPARK RD
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44129-1219
Practice Address - Country:US
Practice Address - Phone:407-351-7080
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NEW SEASON OF OHIO, LP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-08-12
Last Update Date:2019-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2800XAmbulatory Health Care FacilitiesClinic/CenterMethadone