Organization
HORIZON RESIDENTIAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEVE IKE IKENYEI (PRESIDENT)
(817) 323-0821
Entity
Organization
Contact information
Practice address
2100 S GREAT SOUTHWEST PKWY, SUITE 601, GRAND PRAIRIE, TX 75051-3543
(817) 323-0821
Mailing address
2100 S GREAT SOUTHWEST PKWY, SUITE 601, GRAND PRAIRIE, TX 75051-3543
(817) 323-0821
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/17/2007
Last updated
07/17/2007
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