Provider Demographics
NPI:1548771900
Name:HORIZON WELLNESS
Entity Type:Organization
Organization Name:HORIZON WELLNESS
Other - Org Name:HORIZON WELLNESS
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OFFICE ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:CROSS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-615-7311
Mailing Address - Street 1:1830 MINERAL SPRING AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02904-3864
Mailing Address - Country:US
Mailing Address - Phone:401-351-1900
Mailing Address - Fax:401-270-3080
Practice Address - Street 1:1339 SMITH ST
Practice Address - Street 2:
Practice Address - City:NORTH PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02908
Practice Address - Country:US
Practice Address - Phone:401-383-9600
Practice Address - Fax:401-369-7474
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-12
Last Update Date:2018-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service