Provider Demographics
NPI:1053635599
Name:NEW HORIZON YOUTH HOMES
Entity type:Organization
Organization Name:NEW HORIZON YOUTH HOMES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:B
Authorized Official - Last Name:GRANADO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-722-2730
Mailing Address - Street 1:PO BOX 2754
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85244-2754
Mailing Address - Country:US
Mailing Address - Phone:480-722-2730
Mailing Address - Fax:480-664-4296
Practice Address - Street 1:4625 S ASH AVE STE J-2
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-6761
Practice Address - Country:US
Practice Address - Phone:480-722-2730
Practice Address - Fax:480-664-4296
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-25
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZBH-3702251S00000X
AZBH-3558251S00000X
AZOTC5864251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health