Provider Demographics
NPI:1578305744
Name:NEW HORIZON BEHAVIORAL & WELLNESS CENTER
Entity type:Organization
Organization Name:NEW HORIZON BEHAVIORAL & WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PMHNP-BC, FNP-BC, CRNP
Authorized Official - Prefix:DR
Authorized Official - First Name:GRACE
Authorized Official - Middle Name:O
Authorized Official - Last Name:AKINPETIDE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, DNP
Authorized Official - Phone:301-381-2320
Mailing Address - Street 1:1400 MERCANTILE LN STE 242
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-5353
Mailing Address - Country:US
Mailing Address - Phone:301-381-2320
Mailing Address - Fax:
Practice Address - Street 1:1400 MERCANTILE LN STE 242
Practice Address - Street 2:
Practice Address - City:LARGO
Practice Address - State:MD
Practice Address - Zip Code:20774-5353
Practice Address - Country:US
Practice Address - Phone:301-381-2320
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-10
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty