Provider Demographics
NPI:1982593141
Name:HOREJS, CORY D
Entity type:Individual
Prefix:
First Name:CORY
Middle Name:D
Last Name:HOREJS
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3020 N ASTAIRE AVE
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:ID
Mailing Address - Zip Code:83646-8238
Mailing Address - Country:US
Mailing Address - Phone:307-534-5079
Mailing Address - Fax:
Practice Address - Street 1:3020 N ASTAIRE AVE
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:ID
Practice Address - Zip Code:83646-8238
Practice Address - Country:US
Practice Address - Phone:307-534-5079
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-01
Last Update Date:2025-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician