Provider Demographics
NPI:1710500616
Name:NEW HORIZON RESIDENTIAL SERVICES L.L.C
Entity Type:Organization
Organization Name:NEW HORIZON RESIDENTIAL SERVICES L.L.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:MOODY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-841-9013
Mailing Address - Street 1:11120 CARVER POND RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28269-5007
Mailing Address - Country:US
Mailing Address - Phone:812-841-9013
Mailing Address - Fax:
Practice Address - Street 1:11120 CARVER POND RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28269-5007
Practice Address - Country:US
Practice Address - Phone:812-841-9013
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-26
Last Update Date:2020-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child
No251S00000XAgenciesCommunity/Behavioral Health