1255380176 NPI number — HORIZON MENTAL HEALTH MANAGEMENT LLC

Table of content: (NPI 1255380176)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1255380176 NPI number — HORIZON MENTAL HEALTH MANAGEMENT LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HORIZON MENTAL HEALTH MANAGEMENT LLC
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:
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:
1255380176
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/15/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 840839
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DALLAS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75284-0839
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
972-420-8200
Provider Business Mailing Address Fax Number:
972-420-7770

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
401 E CORPORATE DR STE 100
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LEWISVILLE
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75057-6426
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
972-420-8200
Provider Business Practice Location Address Fax Number:
972-420-7770
Provider Enumeration Date:
05/08/2006

Additional Information

Authorized Official

Authorized Official Last Name:
FILTON
Authorized Official First Name:
STEVE
Authorized Official Middle Name:
Authorized Official Title or Position:
SVP/CFO
Authorized Official Telephone Number:
610-768-3300

Provider Taxonomy Codes

  • Taxonomy code: 2084P0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 000013192 . This is a "MEDICARE - WISCONSIN PHYSICIANS SERVICE INSURANCE CORP" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 168242 MOBILE IMC , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 102G709179 . This is a "MEDICARE, GROUP - CAHABA GBA" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 103G702344 . This is a "MEDICARE, GROUP - CAHABA GBA" identifier , issued by the state of ( TN ) . This identifiers is of the category "OTHER".
  • Identifier: DU3470 . This is a "RR MEDICARE" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: DO1307 . This is a "RR MEDICARE" identifier , issued by the state of ( MS ) . This identifiers is of the category "OTHER".
  • Identifier: 150232 NORTH BALDWIN , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1527956 , issued by the state of ( TN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 167651 OAKWOOD , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 369667 . This is a "MEDICARE, NOVITAS" identifier , issued by the state of ( AR ) . This identifiers is of the category "OTHER".
  • Identifier: C02158 . This is a "MEDICARE, NOVITAS" identifier , issued by the state of ( MS ) . This identifiers is of the category "OTHER".
  • Identifier: DN8357 . This is a "RR MEDICARE" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 207379002 , issued by the state of ( AR ) . This identifiers is of the category "MEDICAID".
  • Identifier: 70064 . This is a "MEDICARE, WPS" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".
  • Identifier: 9014277 , issued by the state of ( MS ) . This identifiers is of the category "MEDICAID".




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