Provider Demographics
NPI:1720157290
Name:NEW HORIZON FAMILY HEALTH SERVICES, INC.
Entity Type:Organization
Organization Name:NEW HORIZON FAMILY HEALTH SERVICES, INC.
Other - Org Name:NEW HORIZON FAMILY DENTAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT & CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:REGINA
Authorized Official - Middle Name:M
Authorized Official - Last Name:MITCHELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-729-8330
Mailing Address - Street 1:PO BOX 287
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29602-0287
Mailing Address - Country:US
Mailing Address - Phone:864-729-8330
Mailing Address - Fax:864-233-2618
Practice Address - Street 1:1 MEMORIAL MEDICAL DR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29605-4407
Practice Address - Country:US
Practice Address - Phone:864-351-2400
Practice Address - Fax:864-351-2420
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-07
Last Update Date:2015-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCZA9439Medicaid