Provider Demographics
NPI:1760933246
Name:HORIZON HEALTH CARE, INC.
Entity Type:Organization
Organization Name:HORIZON HEALTH CARE, INC.
Other - Org Name:FAITH DENTAL CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
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:605-772-4514
Mailing Address - Street 1:112 N 2ND AVE. W
Mailing Address - Street 2:PO BOX 577
Mailing Address - City:FAITH
Mailing Address - State:SD
Mailing Address - Zip Code:57626-0577
Mailing Address - Country:US
Mailing Address - Phone:605-967-2644
Mailing Address - Fax:605-967-2844
Practice Address - Street 1:112 N 2ND AVE. W
Practice Address - Street 2:
Practice Address - City:FAITH
Practice Address - State:SD
Practice Address - Zip Code:57626-0577
Practice Address - Country:US
Practice Address - Phone:605-967-2644
Practice Address - Fax:605-967-2844
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HORIZON HEALTH CARE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-10-19
Last Update Date:2016-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
No261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental