Provider Demographics
NPI:1568558831
Name:HORIZON HOUSE
Entity Type:Organization
Organization Name:HORIZON HOUSE
Other - Org Name:CORTLAND CO. MENTAL HEALTH
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR OF COMMUNITY SERVICES
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:D
Authorized Official - Last Name:THAYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:607-758-6110
Mailing Address - Street 1:7 CLAYTON AVENUE
Mailing Address - Street 2:
Mailing Address - City:CORTLAND
Mailing Address - State:NY
Mailing Address - Zip Code:13045
Mailing Address - Country:US
Mailing Address - Phone:607-753-6751
Mailing Address - Fax:607-756-4306
Practice Address - Street 1:7 CLAYTON AVENUE
Practice Address - Street 2:
Practice Address - City:CORTLAND
Practice Address - State:NY
Practice Address - Zip Code:13045
Practice Address - Country:US
Practice Address - Phone:607-758-6100
Practice Address - Fax:607-758-6116
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-05
Last Update Date:2012-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY043908-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty