Provider Demographics
NPI:1679300115
Name:GREAT HORIZONS
Entity type:Organization
Organization Name:GREAT HORIZONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MISS
Authorized Official - First Name:DEVONA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:TOWNSEND
Authorized Official - Suffix:
Authorized Official - Credentials:QMHS
Authorized Official - Phone:419-464-5124
Mailing Address - Street 1:4120 THORNTON AVE
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43612-1751
Mailing Address - Country:US
Mailing Address - Phone:419-469-7790
Mailing Address - Fax:
Practice Address - Street 1:4120 THORNTON AVE
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43612-1751
Practice Address - Country:US
Practice Address - Phone:419-469-7790
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-18
Last Update Date:2024-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management
No253Z00000XAgenciesIn Home Supportive Care