Provider Demographics
NPI:1649692997
Name:NEW HORIZONS HEALTH SERVICES PLLC
Entity type:Organization
Organization Name:NEW HORIZONS HEALTH SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:MINASIAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:231-519-2966
Mailing Address - Street 1:575 40TH ST
Mailing Address - Street 2:
Mailing Address - City:NEWAYGO
Mailing Address - State:MI
Mailing Address - Zip Code:49337-8775
Mailing Address - Country:US
Mailing Address - Phone:231-519-2966
Mailing Address - Fax:
Practice Address - Street 1:575 40TH ST
Practice Address - Street 2:
Practice Address - City:NEWAYGO
Practice Address - State:MI
Practice Address - Zip Code:49337-8775
Practice Address - Country:US
Practice Address - Phone:231-519-2966
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-06
Last Update Date:2014-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIMM072794207QH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4517264Medicaid
MI4517264Medicaid