Healthcare Provider Details
I. General information
NPI: 1639613938
Provider Name (Legal Business Name): HORIZONS SPECIALIZED SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/06/2016
Last Update Date: 12/06/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
626 BREEZE ST
CRAIG CO
81625-2504
US
IV. Provider business mailing address
PO BOX 774867
STEAMBOAT SPRINGS CO
80477-4867
US
V. Phone/Fax
- Phone: 970-824-7804
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251C00000X |
| Taxonomy | Developmentally Disabled Services Day Training Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 373H00000X |
| Taxonomy | Day Training/Habilitation Specialist |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 376J00000X |
| Taxonomy | Homemaker |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SUSAN
MIZEN
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 970-879-4466