Provider Demographics
NPI:1801185301
Name:HORIZON SENIOR CARE INC
Entity Type:Organization
Organization Name:HORIZON SENIOR CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMBER
Authorized Official - Middle Name:S
Authorized Official - Last Name:STASIAK
Authorized Official - Suffix:
Authorized Official - Credentials:PA-C
Authorized Official - Phone:972-839-6099
Mailing Address - Street 1:229 BRADFIELD LN
Mailing Address - Street 2:
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75087-9272
Mailing Address - Country:US
Mailing Address - Phone:972-839-6099
Mailing Address - Fax:
Practice Address - Street 1:229 BRADFIELD LN
Practice Address - Street 2:
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75087-9272
Practice Address - Country:US
Practice Address - Phone:972-839-6099
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-05
Last Update Date:2011-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA00801364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental HealthGroup - Single Specialty