Provider Demographics
NPI:1629187414
Name:HORIZON HOME HEALTHCARE, LLC.
Entity Type:Organization
Organization Name:HORIZON HOME HEALTHCARE, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DON
Authorized Official - Prefix:MS
Authorized Official - First Name:NICHOLE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:NORVELL
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:937-410-3838
Mailing Address - Street 1:410 CORPORATE CENTER DR
Mailing Address - Street 2:
Mailing Address - City:VANDALIA
Mailing Address - State:OH
Mailing Address - Zip Code:45377-1164
Mailing Address - Country:US
Mailing Address - Phone:937-264-3155
Mailing Address - Fax:937-264-3159
Practice Address - Street 1:410 CORPORATE CENTER DR
Practice Address - Street 2:
Practice Address - City:VANDALIA
Practice Address - State:OH
Practice Address - Zip Code:45377-1164
Practice Address - Country:US
Practice Address - Phone:937-264-3155
Practice Address - Fax:937-264-3159
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-29
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2459058Medicaid
OH2459058Medicaid