Provider Demographics
NPI:1033291265
Name:HORIZONS, A FAMILY SERVICE ALLIANCE
Entity Type:Organization
Organization Name:HORIZONS, A FAMILY SERVICE ALLIANCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MOLLY
Authorized Official - Middle Name:M
Authorized Official - Last Name:GANSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:319-398-3943
Mailing Address - Street 1:819 5TH ST SE
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52401-2128
Mailing Address - Country:US
Mailing Address - Phone:319-398-3943
Mailing Address - Fax:888-632-7914
Practice Address - Street 1:819 5TH ST SE
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52401-2128
Practice Address - Country:US
Practice Address - Phone:319-398-3943
Practice Address - Fax:888-632-7914
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-19
Last Update Date:2011-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA=========OtherTAX ID NUMBER
IA=========OtherTAX ID NUMBER