| New Horizons Community Support Services, Inc. | |
|
2013 Williams St Jefferson City MO 65109-4771 | |
| (573) 636-8108 | |
| Not Available |
| Full Name | New Horizons Community Support Services, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 2013 Williams St, Jefferson City, Missouri |
| Authorized Official Name and Position | Chi L Cheung (PRESIDENT) |
| Authorized Official Contact | 5736368108 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| New Horizons Community Support Services, Inc. 2013 Williams St Jefferson City MO 65109-4771 Ph: (573) 636-8108 | New Horizons Community Support Services, Inc. 2013 Williams St Jefferson City MO 65109-4771 Ph: (573) 636-8108 |
| NPI Number | 1669547485 |
|---|---|
| Provider Enumeration Date | 11/21/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 0042239873 |
|---|---|
| Medicare Enrollment ID | O20051122000108 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669547485 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | 2456-8434 (Missouri) | Primary |
| Provider Name | Sarmistha Bhalla |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1083791792 PECOS PAC ID: 4183770589 Enrollment ID: I20090928000319 |
| Provider Name | Fatten F Elkomy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316388754 PECOS PAC ID: 2466686969 Enrollment ID: I20131017000403 |
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