Provider Demographics
NPI:1437917325
Name:HORIZONS ENRICHMENT CENTER LLC
Entity Type:Organization
Organization Name:HORIZONS ENRICHMENT CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:JEROME
Authorized Official - Last Name:FABER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:573-275-6404
Mailing Address - Street 1:636 QUAIL CRK
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MO
Mailing Address - Zip Code:63755-3805
Mailing Address - Country:US
Mailing Address - Phone:573-275-6404
Mailing Address - Fax:
Practice Address - Street 1:2100 THEMIS ST STE 103C
Practice Address - Street 2:
Practice Address - City:CAPE GIRARDEAU
Practice Address - State:MO
Practice Address - Zip Code:63701-5157
Practice Address - Country:US
Practice Address - Phone:573-290-5115
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-06
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities