MEDICARE: HORIZONS, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	2334	WI

General Provider Information

NPI Number	:	1033343868
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HORIZONS, INC

Provider Business Mailing Address
First Line	:	2511 W VINE ST
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53205-1450
Country	:	US
Telephone Number	:	414-342-3237
Fax Number	:	414-342-3258

Provider Business Practice Location Address
First Line	:	2511 W VINE ST
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53205-1450
Country	:	US
Telephone Number	:	414-342-3237
Fax Number	:	414-342-3258

Authorized Official
Title or Position	:	DIRECTOR OF OUTPATIENT SERVICES
Name	:	MS. STACEY L YONKOSKI
Credential	:	LCSW, CSAC
Telephone Number	:	414-342-3237

Provider Enumeration Date	:	05/07/2009
Last Update Date	:	07/01/2009

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