Healthcare Provider Details

I. General information

NPI: 1508941105
Provider Name (Legal Business Name): HORIZON BEHAVIORAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2006
Last Update Date: 04/12/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3410 OLD FOREST RD
LYNCHBURG VA
24501-2915
US

IV. Provider business mailing address

620 COURT ST
LYNCHBURG VA
24504-1312
US

V. Phone/Fax

Practice location:
  • Phone: 434-455-5342
  • Fax: 434-485-8877
Mailing address:
  • Phone: 434-847-8035
  • Fax: 434-485-8877

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: JAMIE BURNETT
Title or Position: CREDENTIALING SPECIALIST
Credential:
Phone: 434-455-5342