Provider Demographics
NPI:1184043671
Name:HORIZON HOME CARE
Entity Type:Organization
Organization Name:HORIZON HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEREK
Authorized Official - Middle Name:
Authorized Official - Last Name:PROCTOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:978-851-7775
Mailing Address - Street 1:2314 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:TEWKSBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01876-3128
Mailing Address - Country:US
Mailing Address - Phone:978-851-7775
Mailing Address - Fax:978-851-7779
Practice Address - Street 1:2314 MAIN ST
Practice Address - Street 2:
Practice Address - City:TEWKSBURY
Practice Address - State:MA
Practice Address - Zip Code:01876-3128
Practice Address - Country:US
Practice Address - Phone:978-851-7775
Practice Address - Fax:978-851-7779
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-10
Last Update Date:2022-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110103288AMedicaid
MA227600Medicare Oscar/Certification