Provider Demographics
NPI:1629376629
Name:HORIZON HOUSE DELAWARE INC
Entity Type:Organization
Organization Name:HORIZON HOUSE DELAWARE INC
Other - Org Name:ECHO CENTER - NEWARK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
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 1:261 CHAPMAN RD
Mailing Address - Street 2:SUITE 100-102
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19702-5423
Mailing Address - Country:US
Mailing Address - Phone:302-266-3246
Mailing Address - Fax:302-266-7990
Practice Address - Street 1:261 CHAPMAN RD
Practice Address - Street 2:SUITE 100-102
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19702-5423
Practice Address - Country:US
Practice Address - Phone:302-266-3246
Practice Address - Fax:302-266-7990
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HORIZON HOUSE DELAWARE INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-03-01
Last Update Date:2011-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE609001251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
DEPTAN 732100Medicare UPIN