Provider Demographics
NPI:1316065428
Name:HORIZON BHC-VINELAND
Entity type:Organization
Organization Name:HORIZON BHC-VINELAND
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:SIMONE
Authorized Official - Middle Name:L
Authorized Official - Last Name:GALLETTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-507-1911
Mailing Address - Street 1:427 W LANDIS AVE
Mailing Address - Street 2:
Mailing Address - City:VINELAND
Mailing Address - State:NJ
Mailing Address - Zip Code:08360-8143
Mailing Address - Country:US
Mailing Address - Phone:856-507-1911
Mailing Address - Fax:856-507-9979
Practice Address - Street 1:427 W LANDIS AVE
Practice Address - Street 2:
Practice Address - City:VINELAND
Practice Address - State:NJ
Practice Address - Zip Code:08360-8143
Practice Address - Country:US
Practice Address - Phone:856-507-1911
Practice Address - Fax:856-507-9979
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0002615Medicare UPIN