Provider Demographics
NPI:1770777401
Name:NEW HORIZONS HOME CARE, INC
Entity type:Organization
Organization Name:NEW HORIZONS HOME CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LEAH
Authorized Official - Middle Name:H
Authorized Official - Last Name:HANES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-677-3843
Mailing Address - Street 1:PO BOX 1969
Mailing Address - Street 2:648 CAROLINA AVE
Mailing Address - City:YADKINVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27055-1969
Mailing Address - Country:US
Mailing Address - Phone:336-677-3843
Mailing Address - Fax:
Practice Address - Street 1:648 CAROLINA AVE
Practice Address - Street 2:
Practice Address - City:YADKINVILLE
Practice Address - State:NC
Practice Address - Zip Code:27055-7759
Practice Address - Country:US
Practice Address - Phone:336-677-3843
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-06
Last Update Date:2013-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHC2413251E00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6600993Medicaid