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General NPI Number Information
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NPI Number | 1699907873
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Entity Type | Organization
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Legal Business Name | HORIZON DAY HEALTH CENTER
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Dates
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Enumeration Date | 08/20/2009
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Last Update Date | 02/01/2011
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Provider Practice Location Address
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Address Line | 1289 E LIVINGSTON AVE
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City | COLUMBUS
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State | OH
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Zip | 43205-2838
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Country | US
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Telephone | 614-579-5382
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Fax |
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Provider Business Mailing Address
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Address Line | 8128 GRISWOLD DR
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City | NEW ALBANY
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State | OH
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Zip | 43054-8169
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Country | US
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Telephone | 614-579-5382
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DWAYNE ALLEN BODRICK
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Credential |
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Telephone | 614-579-5382
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 2951024
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License Number State | OH
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