Organization
NEW HORIZONS YOUTH MINISTRIES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TIMOTHY G BLOSSOM (CHIEF EXECUTIVE OFFICER)
(765) 668-4009
Entity
Organization
Contact information
Practice address
1002 S 350 E, MARION, IN 46953-9559
(765) 668-4009
(765) 662-1407
Mailing address
1002 S 350 E, MARION, IN 46953-9559
(765) 668-4009
(765) 662-1407
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
39001934A
IN
104100000X
Social Worker
33001688A
IN
1041C0700X
Clinical Social Worker
34002547A
IN
106H00000X
Marriage & Family Therapist
35000968A
IN
106H00000X
Marriage & Family Therapist
35001283A
IN
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
15546093333447
IN
Other
Enumeration date
02/02/2010
Last updated
02/02/2010
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