Provider Demographics
NPI:1528873742
Name:HORIZON RENEWAL CENTRE
Entity type:Organization
Organization Name:HORIZON RENEWAL CENTRE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TITUS
Authorized Official - Middle Name:LAWA
Authorized Official - Last Name:MWANGI
Authorized Official - Suffix:
Authorized Official - Credentials:BSN
Authorized Official - Phone:763-381-2808
Mailing Address - Street 1:7330 SW TRILLIUM AVE
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97008-5750
Mailing Address - Country:US
Mailing Address - Phone:763-381-2808
Mailing Address - Fax:
Practice Address - Street 1:7330 SW TRILLIUM AVE
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97008-5750
Practice Address - Country:US
Practice Address - Phone:763-381-2808
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-13
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities