NPIMap

Organization Active NPI

New Horizons Group Home

  • Mental Illness Intermediate Care Facility
  • Fayetteville, NC
National Provider Identifier
1164641601
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Intermediate Care FacilityTaxonomy code 310500000X
License
MHL-026-835 Issued in NC
Legal business name
NEW HORIZONS GROUP HOME
Practice address
3319 Auburn Dr
Fayetteville, NC 28306-9353
Phone
(910) 425-5725
NPI assigned
Apr 24, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Miss Donna D. P. Black, R.N.
Title
Chief Executive Officer
Phone
(910) 574-7239

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Intermediate Care Facility 310500000X MHL-026-835 NC Primary

Addresses

Primary practice location

3319 Auburn Dr
Fayetteville, NC 28306-9353

Mailing address

2433 Gray Goose Loop
Fayetteville, NC 28306-7796
Phone (910) 425-7424

National Provider Directory

National Provider Directory
Tax ID family
New Horizons Group Home2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1164641601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2433 GRAY GOOSE LOOP",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283067796",
            "telephone_number": "910-425-7424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3319 AUBURN DR",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283069353",
            "telephone_number": "910-425-5725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW HORIZONS GROUP HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BLACK",
        "authorized_official_first_name": "DONNA",
        "authorized_official_middle_name": "D. P.",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "910-574-7239",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "R.N."
    },
    "taxonomies": [
        {
            "code": "310500000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Mental Illness",
            "state": "NC",
            "license": "MHL-026-835",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.