Provider Demographics
NPI:1629603220
Name:HORIZON SCIENCE ACADEMY-BELMONT
Entity Type:Organization
Organization Name:HORIZON SCIENCE ACADEMY-BELMONT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VENDOR
Authorized Official - Prefix:
Authorized Official - First Name:BRYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:PULLEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:309-839-2058
Mailing Address - Street 1:2456 N MANGO AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60639-2313
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2456 N MANGO AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60639-2313
Practice Address - Country:US
Practice Address - Phone:773-237-2702
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CONCEPT SCHOOLS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-03-04
Last Update Date:2020-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)