Provider Demographics
NPI:1770119547
Name:NEW HORIZONS ADULT SUPPORTIVE SERVICES & CARE, INC.
Entity type:Organization
Organization Name:NEW HORIZONS ADULT SUPPORTIVE SERVICES & CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:ILIA
Authorized Official - Middle Name:E
Authorized Official - Last Name:FUSTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-801-8938
Mailing Address - Street 1:712 NEWARK AVE
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH
Mailing Address - State:NJ
Mailing Address - Zip Code:07208-3540
Mailing Address - Country:US
Mailing Address - Phone:908-353-3530
Mailing Address - Fax:908-353-3529
Practice Address - Street 1:712 NEWARK AVE
Practice Address - Street 2:
Practice Address - City:ELIZABETH
Practice Address - State:NJ
Practice Address - Zip Code:07208-3540
Practice Address - Country:US
Practice Address - Phone:908-353-3530
Practice Address - Fax:908-353-3529
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-12
Last Update Date:2020-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0450465603OtherNJ 10-DIGIT ID