Provider Demographics
NPI:1932257383
Name:HALCYON HORIZONS, INC.
Entity type:Organization
Organization Name:HALCYON HORIZONS, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:M
Authorized Official - Last Name:MANSON
Authorized Official - Suffix:
Authorized Official - Credentials:CADC-CS CA
Authorized Official - Phone:831-219-0005
Mailing Address - Street 1:P.O. BOX 1690
Mailing Address - Street 2:
Mailing Address - City:APTOS
Mailing Address - State:CA
Mailing Address - Zip Code:95001
Mailing Address - Country:US
Mailing Address - Phone:831-768-7190
Mailing Address - Fax:831-722-1613
Practice Address - Street 1:262 GAFFEY ROAD
Practice Address - Street 2:
Practice Address - City:WATSONVILLE
Practice Address - State:CA
Practice Address - Zip Code:95076
Practice Address - Country:US
Practice Address - Phone:831-768-7190
Practice Address - Fax:831-722-1613
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-08
Last Update Date:2015-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA090018AN324500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility