Basic Information
| Provider Information | |||||||||
| NPI: | 1326080904 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | DARLIN INC DBA HORIZON SERVICES | ||||||||
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| Mailing Information | |||||||||
| Address1: | 151 S WALNUT ST | ||||||||
| Address2: | SUITE A-1 | ||||||||
| City: | LAS CRUCES | ||||||||
| State: | NM | ||||||||
| PostalCode: | 880012605 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5755275770 | ||||||||
| FaxNumber: | 5755321928 | ||||||||
| Practice Location | |||||||||
| Address1: | 151 S WALNUT ST | ||||||||
| Address2: | SUITE A-1 | ||||||||
| City: | LAS CRUCES | ||||||||
| State: | NM | ||||||||
| PostalCode: | 880012605 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5755275770 | ||||||||
| FaxNumber: | 5755321928 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/11/2006 | ||||||||
| LastUpdateDate: | 03/24/2014 | ||||||||
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| AuthorizedOfficialLastName: | KEMP | ||||||||
| AuthorizedOfficialFirstName: | LINDA | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 5755275770 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | N | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Social Worker | 101YM0800X | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Counselor | Mental Health |
ID Information
| ID | Type | State | Issuer | Description | D3972 | 05 | NM | MEDICAID | 31306560 | 05 | NM | MEDICAID |