Provider Demographics
NPI:1316684459
Name:JON FOUTS DBA HORIZONS EAST LLC
Entity type:Organization
Organization Name:JON FOUTS DBA HORIZONS EAST LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JON
Authorized Official - Middle Name:W
Authorized Official - Last Name:FOUTS
Authorized Official - Suffix:
Authorized Official - Credentials:LISW-S
Authorized Official - Phone:740-877-8115
Mailing Address - Street 1:24 FRONT ST STE 203
Mailing Address - Street 2:
Mailing Address - City:PATASKALA
Mailing Address - State:OH
Mailing Address - Zip Code:43062-8357
Mailing Address - Country:US
Mailing Address - Phone:740-877-8115
Mailing Address - Fax:
Practice Address - Street 1:24 FRONT ST STE 203
Practice Address - Street 2:
Practice Address - City:PATASKALA
Practice Address - State:OH
Practice Address - Zip Code:43062-8357
Practice Address - Country:US
Practice Address - Phone:740-877-8115
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-19
Last Update Date:2022-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty