1861523961 NPI number — NEW HORIZON YOUTH HOMES, INC.

Table of content: KURT MAURICE WRIGHT JR. (NPI 1043879992)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1861523961 NPI number — NEW HORIZON YOUTH HOMES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NEW HORIZON YOUTH HOMES, 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:
1861523961
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 2754
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHANDLER
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85244-2754
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
480-722-2730
Provider Business Mailing Address Fax Number:
480-664-4296

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6726 W CHOLLA ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PEORIA
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85345-5850
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
480-722-2730
Provider Business Practice Location Address Fax Number:
480-664-4296
Provider Enumeration Date:
03/08/2007

Additional Information

Authorized Official

Authorized Official Last Name:
GRANADO
Authorized Official First Name:
THOMAS
Authorized Official Middle Name:
BEN
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
480-722-2730

Provider Taxonomy Codes

  • Taxonomy code: 322D00000X , with the licence number:  BH-2170 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2024 www.npivalidator.com