Provider Demographics
NPI:1295105559
Name:NEW HORIZONS FOR COMMUNITY-BOUND INDIVIDUALS, INC.
Entity type:Organization
Organization Name:NEW HORIZONS FOR COMMUNITY-BOUND INDIVIDUALS, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ED
Authorized Official - Middle Name:
Authorized Official - Last Name:ALDAMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:305-887-1535
Mailing Address - Street 1:1340 S.E. 9TH AVENUE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33010-5947
Mailing Address - Country:US
Mailing Address - Phone:305-887-1535
Mailing Address - Fax:305-887-4948
Practice Address - Street 1:1340 SE 9TH AVENUE
Practice Address - Street 2:SUITE 2
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33010-5947
Practice Address - Country:US
Practice Address - Phone:305-887-1535
Practice Address - Fax:305-887-4948
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-30
Last Update Date:2015-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL320600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL683071496Medicaid