Provider Demographics
NPI:1376997627
Name:HORIZON RIDGE CLINIC LLC
Entity Type:Organization
Organization Name:HORIZON RIDGE CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:A
Authorized Official - Last Name:EDDINS
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:702-489-2889
Mailing Address - Street 1:3160 W SAHARA AVE STE A11
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102-3215
Mailing Address - Country:US
Mailing Address - Phone:702-489-2889
Mailing Address - Fax:702-489-8264
Practice Address - Street 1:1670 S FLAMINGO RD SUITE A
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-5120
Practice Address - Country:US
Practice Address - Phone:702-489-2889
Practice Address - Fax:702-780-0755
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-22
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder