Healthcare Provider Details

I. General information

NPI: 1538392477
Provider Name (Legal Business Name): HORIZON HOUSE DELAWARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2009
Last Update Date: 08/26/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3120 NAAMANS RD
WILMINGTON DE
19810-2139
US

IV. Provider business mailing address

120 S 30TH ST
PHILADELPHIA PA
19104-3403
US

V. Phone/Fax

Practice location:
  • Phone: 302-477-1979
  • Fax: 302-477-1179
Mailing address:
  • Phone: 215-386-3838
  • Fax: 215-438-4872

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TM1800X
TaxonomyIntellectual & Developmental Disabilities Psychologist
License Number
License Number State

VIII. Authorized Official

Name: MR. JEFFREY J.W. WILUSH
Title or Position: PRESIDENT/CEO
Credential:
Phone: 215-386-3838