Provider Demographics
NPI:1366710097
Name:HORIZON SCIENCE ACADEMY COLUMBUS ELEMENTARY
Entity type:Organization
Organization Name:HORIZON SCIENCE ACADEMY COLUMBUS ELEMENTARY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAID ENROLLMENT SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:TODD
Authorized Official - Middle Name:K
Authorized Official - Last Name:LEVESQUE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-922-9300
Mailing Address - Street 1:2835 MORSE RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43231-6033
Mailing Address - Country:US
Mailing Address - Phone:614-475-4585
Mailing Address - Fax:
Practice Address - Street 1:2835 MORSE RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43231-6033
Practice Address - Country:US
Practice Address - Phone:614-475-4585
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-08
Last Update Date:2011-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)