Organization Active NPI

Healthy Horizons LLC

  • Social Worker
  • Jackson, MI
National Provider Identifier
1417625435
Registry record updated Sep 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Legal business name
HEALTHY HORIZONS LLC
Practice address
1200 N West Ave Ste 809
Jackson, MI 49202-2196
Phone
(517) 300-7570
Fax
(517) 796-4561
NPI assigned
Sep 3, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dawn Del Rio, LMSW ACSW, PHDNPI 1952356081
Title
Owner
Phone
(517) 300-7570

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 104100000X Primary

Addresses

Primary practice location

1200 N West Ave Ste 809
Jackson, MI 49202-2196

Mailing address

1200 N West Ave Ste 809
Jackson, MI 49202-2196
Phone (517) 300-7570

Other identifiers 1

IdentifierTypeStateIssuer
6801079615OtherMILICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL 11751964 Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211011001891 MI Part B Supplier - Clinic/Group Practice 2163820853 Receives reassigned benefits from 1 practitioner
Practice locations: Jackson, MI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1630627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632268800000",
    "number": "1417625435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 N WEST AVE STE 809",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492022196",
            "telephone_number": "517-300-7570",
            "fax_number": "517-796-4661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 N WEST AVE STE 809",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492022196",
            "telephone_number": "517-300-7570",
            "fax_number": "517-796-4561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHY HORIZONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-03",
        "last_updated": "2021-09-22",
        "certification_date": "2021-09-22",
        "status": "A",
        "authorized_official_last_name": "DEL RIO",
        "authorized_official_first_name": "DAWN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "517-300-7570",
        "authorized_official_credential": "LMSW ACSW, PHD"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "6801079615",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "11751964",
            "affiliation": "N",
            "endpointDescription": "CAQH",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "None",
            "address_1": "1200 N West Ave Ste 809",
            "city": "Jackson",
            "state": "MI",
            "country_code": "US",
            "postal_code": "492022196",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.