Provider Demographics
NPI:1356630461
Name:HORIZON OF HOPE
Entity Type:Organization
Organization Name:HORIZON OF HOPE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUBSTANCE ABUSE COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:TERRI
Authorized Official - Middle Name:LYNNE
Authorized Official - Last Name:PATTERSON
Authorized Official - Suffix:
Authorized Official - Credentials:CCJP
Authorized Official - Phone:573-431-5903
Mailing Address - Street 1:PO BOX 647
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:MO
Mailing Address - Zip Code:63640-0647
Mailing Address - Country:US
Mailing Address - Phone:573-431-5903
Mailing Address - Fax:573-431-5966
Practice Address - Street 1:201 WEIR ST STE A
Practice Address - Street 2:
Practice Address - City:LEADINGTON
Practice Address - State:MO
Practice Address - Zip Code:63601-4474
Practice Address - Country:US
Practice Address - Phone:573-431-5903
Practice Address - Fax:573-431-5966
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-30
Last Update Date:2011-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO501839251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health