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General NPI Number Information
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NPI Number | 1265409049
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Entity Type | Organization
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Legal Business Name | HORIZON HOUSE I
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Dates
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Enumeration Date | 03/01/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2169 ERMINE AVE
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City | VENTURA
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State | CA
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Zip | 93003-6812
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Country | US
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Telephone | 805-647-4555
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Fax | 805-647-0406
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Provider Business Mailing Address
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Address Line | 2169 ERMINE AVE
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City | VENTURA
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State | CA
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Zip | 93003-6812
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Country | US
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Telephone | 805-647-4555
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Fax | 805-647-0406
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Authorized Official
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Title or Position | CEO
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Name | MS. WANDA KRUFT
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Credential |
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Telephone | 805-647-4555
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 315P00000X
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Taxonomy Name | Intellectual Disabilities Intermediate Care Facility
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License Number |
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License Number State | CA
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