=====================================================
General NPI Number Information
=====================================================
NPI Number | 1154733442
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HORIZON COUNSELING & EDUCATION CENTER, LL
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/21/2014
-----------------------------------------------------
Last Update Date | 05/21/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3500 S WADSWORTH BLVD STE 407
-----------------------------------------------------
City | LAKEWOOD
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80235-2053
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 303-716-3326
-----------------------------------------------------
Fax | 303-716-3011
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3500 S WADSWORTH BLVD
-----------------------------------------------------
City | LAKEWOOD
-----------------------------------------------------
State | CO
-----------------------------------------------------
Zip | 80235-2019
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 303-716-3326
-----------------------------------------------------
Fax | 303-716-3011
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | TAMMY LOVEJOY
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 303-716-3326
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 302R00000X
-----------------------------------------------------
Taxonomy Name | Health Maintenance Organization
-----------------------------------------------------
License Number | 0000085
-----------------------------------------------------
License Number State | CO
-----------------------------------------------------