Provider Demographics
NPI:1942698766
Name:NEW HORIZONS NORTH, INC.
Entity Type:Organization
Organization Name:NEW HORIZONS NORTH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:LANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-682-7171
Mailing Address - Street 1:324 W BAYFIELD ST
Mailing Address - Street 2:
Mailing Address - City:WASHBURN
Mailing Address - State:WI
Mailing Address - Zip Code:54891-1136
Mailing Address - Country:US
Mailing Address - Phone:715-373-5505
Mailing Address - Fax:715-373-2203
Practice Address - Street 1:324 W BAYFIELD ST
Practice Address - Street 2:
Practice Address - City:WASHBURN
Practice Address - State:WI
Practice Address - Zip Code:54891-1136
Practice Address - Country:US
Practice Address - Phone:715-373-5505
Practice Address - Fax:715-373-2203
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-31
Last Update Date:2014-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1061-800251V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI3054OtherWISCONSIN STATE CCS CERTIFICATION LICENSE