Provider Demographics
NPI:1629350285
Name:HORIZON EDUCATIONAL SERVICES OF COLUMBUS
Entity Type:Organization
Organization Name:HORIZON EDUCATIONAL SERVICES OF COLUMBUS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAID ENROLLMENT SPECIALIST
Authorized Official - Prefix:MR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:
Authorized Official - Last Name:LEVESQUE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-922-9300
Mailing Address - Street 1:1070 MORSE RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43229-6290
Mailing Address - Country:US
Mailing Address - Phone:614-846-7696
Mailing Address - Fax:208-922-9351
Practice Address - Street 1:1070 MORSE RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43229-6290
Practice Address - Country:US
Practice Address - Phone:614-846-7696
Practice Address - Fax:208-922-9351
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-09
Last Update Date:2011-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)