Basic Information
| Provider Information | |||||||||
| NPI: | 1326344409 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | HORIZON HEALTH SERVICES | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6301 INDUCON DRIVE EAST | ||||||||
| Address2: | |||||||||
| City: | SANBORN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 14132 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7167312030 | ||||||||
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| Practice Location | |||||||||
| Address1: | 6301 INDUCON DRIVE EAST | ||||||||
| Address2: | |||||||||
| City: | SANBORN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 14132 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7167312030 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/07/2011 | ||||||||
| LastUpdateDate: | 02/07/2011 | ||||||||
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| AuthorizedOfficialLastName: | BLY | ||||||||
| AuthorizedOfficialFirstName: | DIANE | ||||||||
| AuthorizedOfficialMiddleName: | MARIE | ||||||||
| AuthorizedOfficialTitleorPosition: | WELLNESS COUNSELOR | ||||||||
| AuthorizedOfficialTelephone: | 7167312030 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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| AuthorizedOfficialCredential: | B.S. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 324500000X | Y | Residential Treatment Facilities | Substance Abuse Rehabilitation Facility |
No ID Information.