Provider Demographics
NPI:1699085936
Name:LIVINGSTON COUNTY NEW HORIZONS
Entity type:Organization
Organization Name:LIVINGSTON COUNTY NEW HORIZONS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:THERESIA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:O'NEAL
Authorized Official - Suffix:
Authorized Official - Credentials:EDUCATION SPECIALIST
Authorized Official - Phone:660-646-1513
Mailing Address - Street 1:920 CLINEFELTER
Mailing Address - Street 2:
Mailing Address - City:CHILLICOTHE
Mailing Address - State:MO
Mailing Address - Zip Code:64601-0203
Mailing Address - Country:US
Mailing Address - Phone:660-646-1513
Mailing Address - Fax:
Practice Address - Street 1:920 CLINEFELTER ST
Practice Address - Street 2:
Practice Address - City:CHILLICOTHE
Practice Address - State:MO
Practice Address - Zip Code:64601-2348
Practice Address - Country:US
Practice Address - Phone:660-646-1513
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-20
Last Update Date:2010-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management