Provider Demographics
NPI:1710366737
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 EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:NORMAN
Authorized Official - Middle Name:E
Authorized Official - Last Name:MUDD
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:480-983-0065
Mailing Address - Fax:480-671-4541
Practice Address - Street 1:980 E. MT. LEMMON ROAD
Practice Address - Street 2:
Practice Address - City:ORACLE
Practice Address - State:AZ
Practice Address - Zip Code:85623
Practice Address - Country:US
Practice Address - Phone:520-896-6019
Practice Address - Fax:480-288-5339
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-22
Last Update Date:2020-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QF0400X
AZOTC5930261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ73674Medicare PIN