Provider Demographics
NPI:1366575268
Name:NEW HORIZONS COMMUNITY SUPPORT SERVICES, INC.
Entity type:Organization
Organization Name:NEW HORIZONS COMMUNITY SUPPORT SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE-PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WILL
Authorized Official - Middle Name:DESHAWN
Authorized Official - Last Name:OUTLAW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-209-5528
Mailing Address - Street 1:126 NC HIGHWAY 42
Mailing Address - Street 2:
Mailing Address - City:COLERAIN
Mailing Address - State:NC
Mailing Address - Zip Code:27924-9018
Mailing Address - Country:US
Mailing Address - Phone:252-794-5549
Mailing Address - Fax:
Practice Address - Street 1:126 NC HIGHWAY 42
Practice Address - Street 2:
Practice Address - City:COLERAIN
Practice Address - State:NC
Practice Address - Zip Code:27924-9018
Practice Address - Country:US
Practice Address - Phone:252-209-5528
Practice Address - Fax:252-794-5549
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health