Healthcare Provider Details

I. General information

NPI: 1376685057
Provider Name (Legal Business Name): HORIZON HOUSE - DELAWARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/12/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 S MADISON ST IST DIVISION
WILMINGTON DE
19801-5116
US

IV. Provider business mailing address

500 S MADISON ST IST DIVISION
WILMINGTON DE
19801-5116
US

V. Phone/Fax

Practice location:
  • Phone: 215-386-3838
  • Fax: 215-438-4872
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 Number1519
License Number StateDE

VIII. Authorized Official

Name: MR. JEFFERY WILUSH
Title or Position: CEO & PRESIDENT
Credential:
Phone: 215-386-3838