Basic Information
| Provider Information | |||||||||
| NPI: | 1477713089 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HORIZON HUMAN SERVICES | ||||||||
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| Mailing Information | |||||||||
| Address1: | 391 DOAT ST | ||||||||
| Address2: | |||||||||
| City: | BUFFALO | ||||||||
| State: | NY | ||||||||
| PostalCode: | 142112147 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7168970826 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3020 BAILEY AVE | ||||||||
| Address2: | |||||||||
| City: | BUFFALO | ||||||||
| State: | NY | ||||||||
| PostalCode: | 142152814 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7168311800 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/17/2008 | ||||||||
| LastUpdateDate: | 06/17/2008 | ||||||||
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| AuthorizedOfficialLastName: | HUDSON | ||||||||
| AuthorizedOfficialFirstName: | MONET | ||||||||
| AuthorizedOfficialMiddleName: | DARCELL | ||||||||
| AuthorizedOfficialTitleorPosition: | CLINIC RN | ||||||||
| AuthorizedOfficialTelephone: | 7168970826 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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| AuthorizedOfficialCredential: | RN | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261Q00000X | NY | Y | Ambulatory Health Care Facilities | Clinic/Center |
No ID Information.