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General NPI Number Information
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NPI Number | 1780878371
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Entity Type | Organization
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Legal Business Name | HORIZON VILLAGE RECOVERY CENTER
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Dates
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Enumeration Date | 08/28/2007
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Last Update Date | 08/28/2007
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Provider Practice Location Address
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Address Line | 314 ELLICOTT ST
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City | BATAVIA
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State | NY
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Zip | 14020-3650
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Country | US
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Telephone | 585-815-0247
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Fax | 585-815-0251
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Provider Business Mailing Address
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Address Line | 3020 BAILEY AVE
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City | BUFFALO
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State | NY
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Zip | 14215-2814
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Country | US
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Telephone | 716-831-1800
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Fax | 716-831-1818
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Authorized Official
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Title or Position | A/R DEPARTMENT MANAGER
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Name | MS. ADRIANE RENE BROCZKOWSKI
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Credential |
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Telephone | 716-831-1800
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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 |
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License Number State | NY
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