Provider Demographics
NPI:1336702612
Name:BLUE HORIZON STAFFING SOLUTIONS LLC
Entity Type:Organization
Organization Name:BLUE HORIZON STAFFING SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHASTITY
Authorized Official - Middle Name:
Authorized Official - Last Name:CORDOVA-HEYWARD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:866-728-1346
Mailing Address - Street 1:41593 WINCHESTER RD STE 200-242
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92590-4860
Mailing Address - Country:US
Mailing Address - Phone:866-728-1346
Mailing Address - Fax:626-800-3454
Practice Address - Street 1:41593 WINCHESTER RD STE 200-242
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92590-4860
Practice Address - Country:US
Practice Address - Phone:866-728-1346
Practice Address - Fax:626-800-3454
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-22
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No385HR2055XRespite Care FacilityRespite CareRespite Care, Mental Illness, Child
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child
No385HR2065XRespite Care FacilityRespite CareRespite Care, Physical Disabilities, Child