1114256104 NPI number — NEW HORIZONS PROFESSIONAL ABA SERVICES INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1114256104 NPI number — NEW HORIZONS PROFESSIONAL ABA SERVICES INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NEW HORIZONS PROFESSIONAL ABA SERVICES INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1114256104
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/06/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
500 W JUBAL EARLY DR
Provider Second Line Business Mailing Address:
SUITE 210
Provider Business Mailing Address City Name:
WINCHESTER
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
22601-6507
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
540-431-5641
Provider Business Mailing Address Fax Number:
540-431-5628

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
500 W JUBAL EARLY DR
Provider Second Line Business Practice Location Address:
SUITE 210
Provider Business Practice Location Address City Name:
WINCHESTER
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22601-6507
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
540-431-5641
Provider Business Practice Location Address Fax Number:
540-431-5628
Provider Enumeration Date:
12/22/2009

Additional Information

Authorized Official

Authorized Official Last Name:
KUSHNER
Authorized Official First Name:
JESSE
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT/OWNER
Authorized Official Telephone Number:
540-431-5641

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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