Provider Demographics
NPI:1457731366
Name:NEW HEIGHTS
Entity Type:Organization
Organization Name:NEW HEIGHTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JACQULINE
Authorized Official - Middle Name:
Authorized Official - Last Name:NWUFOH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-512-2857
Mailing Address - Street 1:1610 JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71202-2030
Mailing Address - Country:US
Mailing Address - Phone:318-512-2857
Mailing Address - Fax:318-324-9647
Practice Address - Street 1:1610 JACKSON ST
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71202-2030
Practice Address - Country:US
Practice Address - Phone:318-512-2857
Practice Address - Fax:318-324-9647
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-05
Last Update Date:2015-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health