1710500616 NPI number — NEW HORIZON RESIDENTIAL SERVICES L.L.C

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 1710500616 NPI number — NEW HORIZON RESIDENTIAL SERVICES L.L.C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NEW HORIZON RESIDENTIAL SERVICES L.L.C
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:
1710500616
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/06/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11120 CARVER POND RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHARLOTTE
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28269-5007
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
812-841-9013
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
11120 CARVER POND RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHARLOTTE
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28269-5007
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
812-841-9013
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/26/2020

Additional Information

Authorized Official

Authorized Official Last Name:
MOODY
Authorized Official First Name:
CHRISTINA
Authorized Official Middle Name:
Authorized Official Title or Position:
EXECTIVE DIRECTOR
Authorized Official Telephone Number:
812-841-9013

Provider Taxonomy Codes

  • Taxonomy code: 251C00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com