Healthcare Provider Details
I. General information
NPI: 1336895994
Provider Name (Legal Business Name): HORIZONS THERAPY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/22/2022
Last Update Date: 08/10/2022
Certification Date: 08/10/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
14 7TH AVE N STE 131
SAINT CLOUD MN
56303-4753
US
IV. Provider business mailing address
3063 12TH AVE N
SARTELL MN
56377-4833
US
V. Phone/Fax
- Phone: 320-460-1664
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM0850X |
| Taxonomy | Adult Mental Health Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JOEL
BERSHOK
Title or Position: OWNER / THERAPIST
Credential: MSW, LICSW
Phone: 320-460-1664