Healthcare Provider Details

I. General information

NPI: 1063321743
Provider Name (Legal Business Name): HORIZON BEHAVIORAL HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/07/2026
Last Update Date: 09/07/2026
Certification Date: 09/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

340 BROAD ST
WINDSOR CT
06095-3030
US

IV. Provider business mailing address

100 STOCKINGMILL RD
WETHERSFIELD CT
06109-3656
US

V. Phone/Fax

Practice location:
  • Phone: 928-395-0955
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: OLUBUNMI OLUGBILE
Title or Position: OWNER
Credential:
Phone: 928-395-0955