Provider Demographics
NPI:1588229827
Name:HORIZON HEALTH AND WELLNESS, INC.
Entity Type:Organization
Organization Name:HORIZON HEALTH AND WELLNESS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:BILLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLLIDAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-983-0065
Mailing Address - Street 1:625 N PLAZA DR
Mailing Address - Street 2:
Mailing Address - City:APACHE JUNCTION
Mailing Address - State:AZ
Mailing Address - Zip Code:85120-5501
Mailing Address - Country:US
Mailing Address - Phone:480-474-5540
Mailing Address - Fax:
Practice Address - Street 1:3180 E 40TH ST STE A
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85365-7772
Practice Address - Country:US
Practice Address - Phone:928-373-6763
Practice Address - Fax:928-344-8950
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HORIZON HEALTH AND WELLNESS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-05-02
Last Update Date:2020-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ138462Medicaid