Provider Demographics
NPI:1962646547
Name:NEW HORIZONS YOUTH SERVICE BUREAU, INC.
Entity type:Organization
Organization Name:NEW HORIZONS YOUTH SERVICE BUREAU, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:WIL
Authorized Official - Middle Name:E
Authorized Official - Last Name:GIRON
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:985-345-1171
Mailing Address - Street 1:PO BOX 1968
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:LA
Mailing Address - Zip Code:70404-1968
Mailing Address - Country:US
Mailing Address - Phone:985-345-1171
Mailing Address - Fax:985-542-9878
Practice Address - Street 1:47257 RIVER RD
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70401-3901
Practice Address - Country:US
Practice Address - Phone:985-345-1171
Practice Address - Fax:985-542-9878
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-27
Last Update Date:2009-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA229251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health