Provider Demographics
NPI:1154592707
Name:NEW HORIZONS COUNSELING SERVICE INC.
Entity type:Organization
Organization Name:NEW HORIZONS COUNSELING SERVICE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:GINA
Authorized Official - Middle Name:TERESA
Authorized Official - Last Name:ORNELAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:623-939-6567
Mailing Address - Street 1:PO BOX 56339
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85079-6339
Mailing Address - Country:US
Mailing Address - Phone:623-939-6567
Mailing Address - Fax:623-939-7365
Practice Address - Street 1:5062 N 19TH AVE STE 102
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85015-3225
Practice Address - Country:US
Practice Address - Phone:623-939-6567
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-21
Last Update Date:2008-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZBH2882251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ102573Medicare PIN