Provider Demographics
NPI:1558335349
Name:HORIZON HEALTH CARE INC
Entity Type:Organization
Organization Name:HORIZON HEALTH CARE INC
Other - Org Name:FAMILY HEALTH CENTER OF EAGLE BUTTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:MENGENHAUSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:605-772-4525
Mailing Address - Street 1:PO BOX 860
Mailing Address - Street 2:8000 E HWY 212
Mailing Address - City:EAGLE BUTTE
Mailing Address - State:SD
Mailing Address - Zip Code:57625-0860
Mailing Address - Country:US
Mailing Address - Phone:605-964-8000
Mailing Address - Fax:605-964-1118
Practice Address - Street 1:8000 E HWY 212
Practice Address - Street 2:
Practice Address - City:EAGLE BUTTE
Practice Address - State:SD
Practice Address - Zip Code:57625-0860
Practice Address - Country:US
Practice Address - Phone:605-964-8000
Practice Address - Fax:605-964-1118
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-16
Last Update Date:2017-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD5350050Medicaid
SD431802Medicare Oscar/Certification
SD431802Medicare Oscar/Certification