Provider Demographics
NPI:1326410739
Name:HORIZON COMMUNITY DEV. CORP.
Entity Type:Organization
Organization Name:HORIZON COMMUNITY DEV. CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:VON
Authorized Official - Last Name:ESSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:423-340-1266
Mailing Address - Street 1:806 DRESDEN AVE
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37604-6324
Mailing Address - Country:US
Mailing Address - Phone:423-340-1266
Mailing Address - Fax:423-928-7700
Practice Address - Street 1:806 DRESDEN AVE
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37604-6324
Practice Address - Country:US
Practice Address - Phone:423-340-1266
Practice Address - Fax:423-928-7700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-25
Last Update Date:2015-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN69122OtherCONTRACTORS LICENSE