Provider Demographics
NPI:1265565931
Name:NEW HORIZONS COMMUNITY SERVICE BOARD
Entity type:Organization
Organization Name:NEW HORIZONS COMMUNITY SERVICE BOARD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:MISS
Authorized Official - First Name:DANA
Authorized Official - Middle Name:DEMPSEY
Authorized Official - Last Name:HILL
Authorized Official - Suffix:
Authorized Official - Credentials:LAPC
Authorized Official - Phone:229-732-5276
Mailing Address - Street 1:201 VILLA NOVA ST
Mailing Address - Street 2:
Mailing Address - City:CUTHBERT
Mailing Address - State:GA
Mailing Address - Zip Code:39840-1037
Mailing Address - Country:US
Mailing Address - Phone:229-732-5276
Mailing Address - Fax:
Practice Address - Street 1:201 VILLA NOVA ST
Practice Address - Street 2:
Practice Address - City:CUTHBERT
Practice Address - State:GA
Practice Address - Zip Code:39840-1037
Practice Address - Country:US
Practice Address - Phone:229-732-5276
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAPC001471101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty