Provider Demographics
NPI:1366745903
Name:NEW HORIZON GROUP HOME, LLC
Entity type:Organization
Organization Name:NEW HORIZON GROUP HOME, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:F
Authorized Official - Last Name:BROCKINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:QUALIFIED PROFESSION
Authorized Official - Phone:910-536-3502
Mailing Address - Street 1:PO BOX 2452
Mailing Address - Street 2:
Mailing Address - City:LUMBERTON
Mailing Address - State:NC
Mailing Address - Zip Code:28359-2452
Mailing Address - Country:US
Mailing Address - Phone:910-536-3502
Mailing Address - Fax:910-674-4488
Practice Address - Street 1:497 NORTHWOODS DR
Practice Address - Street 2:
Practice Address - City:RAEFORD
Practice Address - State:NC
Practice Address - Zip Code:28376-5820
Practice Address - Country:US
Practice Address - Phone:910-536-3502
Practice Address - Fax:910-674-4488
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-20
Last Update Date:2010-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health