Provider Demographics
NPI:1568714756
Name:HORIZON HOUSE, INC.
Entity Type:Organization
Organization Name:HORIZON HOUSE, INC.
Other - Org Name:HORIZON HOUSE, INC. -PACT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:WJ
Authorized Official - Last Name:WILUSH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-386-3838
Mailing Address - Street 1:1601 PARKLANE RD
Mailing Address - Street 2:
Mailing Address - City:SWARTHMORE
Mailing Address - State:PA
Mailing Address - Zip Code:19081-2331
Mailing Address - Country:US
Mailing Address - Phone:610-328-2044
Mailing Address - Fax:610-328-1562
Practice Address - Street 1:1601 PARKLANE RD
Practice Address - Street 2:
Practice Address - City:SWARTHMORE
Practice Address - State:PA
Practice Address - Zip Code:19081-2331
Practice Address - Country:US
Practice Address - Phone:610-328-2044
Practice Address - Fax:610-328-1562
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-11
Last Update Date:2012-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA100003239Medicaid
PA052071-P5KMedicare PIN