1205100831 NPI number — HORIZON BEHAVIORAL HEALTH

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1205100831 NPI number — HORIZON BEHAVIORAL HEALTH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HORIZON BEHAVIORAL HEALTH
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1205100831
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/03/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 6316
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LYNCHBURG
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
24505-6316
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
434-485-8862
Provider Business Mailing Address Fax Number:
434-485-8877

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
722 A OLD GRAVES MILL ROAD
Provider Second Line Business Practice Location Address:
PEARSON HOUSE
Provider Business Practice Location Address City Name:
LYNCHBURG
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
24501
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
434-485-8861
Provider Business Practice Location Address Fax Number:
434-485-8877
Provider Enumeration Date:
02/29/2012

Additional Information

Authorized Official

Authorized Official Last Name:
LUCY
Authorized Official First Name:
MELISSA
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO / EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
434-455-7080

Provider Taxonomy Codes

  • Taxonomy code: 315P00000X , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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