Provider Demographics
NPI:1760693758
Name:A BRAND NEW HORIZON
Entity type:Organization
Organization Name:A BRAND NEW HORIZON
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:JACQUE
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:GLUECKERT
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:937-233-3720
Mailing Address - Street 1:4752 FISHBURG ROAD
Mailing Address - Street 2:SUITE G
Mailing Address - City:HUBER HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:45424-5455
Mailing Address - Country:US
Mailing Address - Phone:937-233-3720
Mailing Address - Fax:937-233-3726
Practice Address - Street 1:4752 FISHBURG ROAD
Practice Address - Street 2:SUITE G
Practice Address - City:HUBER HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:45424-5455
Practice Address - Country:US
Practice Address - Phone:937-233-3720
Practice Address - Fax:937-233-3726
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2024-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health