Provider Demographics
NPI:1497375182
Name:RED-HORIZON HOME HEALTH CARE LLC
Entity Type:Organization
Organization Name:RED-HORIZON HOME HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KRISTI
Authorized Official - Middle Name:
Authorized Official - Last Name:REDDON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:307-421-0239
Mailing Address - Street 1:433 E 19TH ST STE 2
Mailing Address - Street 2:
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82001-4992
Mailing Address - Country:US
Mailing Address - Phone:307-421-0239
Mailing Address - Fax:
Practice Address - Street 1:433 E 19TH ST STE 2
Practice Address - Street 2:
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82001-4992
Practice Address - Country:US
Practice Address - Phone:307-421-0239
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-22
Last Update Date:2020-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY123OtherVA NON-SKILLED