Provider Demographics
NPI:1417625435
Name:HEALTHY HORIZONS LLC
Entity Type:Organization
Organization Name:HEALTHY HORIZONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:DEL RIO
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW ACSW, PHD
Authorized Official - Phone:517-300-7570
Mailing Address - Street 1:1200 N WEST AVE STE 809
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49202-2196
Mailing Address - Country:US
Mailing Address - Phone:517-300-7570
Mailing Address - Fax:517-796-4661
Practice Address - Street 1:1200 N WEST AVE STE 809
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49202-2196
Practice Address - Country:US
Practice Address - Phone:517-300-7570
Practice Address - Fax:517-796-4561
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-03
Last Update Date:2021-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI6801079615OtherLICENSE