Healthcare Provider Details

I. General information

NPI: 1962343475
Provider Name (Legal Business Name): HORIZON HOUSE DELAWARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/01/2026
Last Update Date: 04/01/2026
Certification Date: 04/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23769 SHORTLY RD
GEORGETOWN DE
19947-4754
US

IV. Provider business mailing address

5901 MARKET ST
PHILADELPHIA PA
19139-3117
US

V. Phone/Fax

Practice location:
  • Phone: 215-386-3838
  • Fax:
Mailing address:
  • Phone: 215-386-3838
  • Fax: 215-438-4872

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: KARIEMAH WHITE-MACK
Title or Position: CSIO
Credential:
Phone: 215-386-3838