Provider Demographics
NPI:1376685057
Name:HORIZON HOUSE - DELAWARE INC
Entity Type:Organization
Organization Name:HORIZON HOUSE - DELAWARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO & PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFERY
Authorized Official - Middle Name:
Authorized Official - Last Name:WILUSH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-386-3838
Mailing Address - Street 1:500 S MADISON ST
Mailing Address - Street 2:IST DIVISION
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19801-5116
Mailing Address - Country:US
Mailing Address - Phone:215-386-3838
Mailing Address - Fax:215-438-4872
Practice Address - Street 1:500 S MADISON ST
Practice Address - Street 2:IST DIVISION
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19801-5116
Practice Address - Country:US
Practice Address - Phone:215-386-3838
Practice Address - Fax:215-438-4872
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE1519261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0000447361Medicaid