Provider Demographics
NPI:1811223704
Name:WELLNESS HORIZONS, LLC
Entity Type:Organization
Organization Name:WELLNESS HORIZONS, LLC
Other - Org Name:DIABETES HEALTH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MS
Authorized Official - First Name:JAN
Authorized Official - Middle Name:LIENKE
Authorized Official - Last Name:BOYER
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MS
Authorized Official - Phone:775-738-9464
Mailing Address - Street 1:PO BOX 16
Mailing Address - Street 2:
Mailing Address - City:ELKO
Mailing Address - State:NV
Mailing Address - Zip Code:89803-0016
Mailing Address - Country:US
Mailing Address - Phone:775-777-9355
Mailing Address - Fax:
Practice Address - Street 1:239 FLORA DR
Practice Address - Street 2:
Practice Address - City:SPRING CREEK
Practice Address - State:NV
Practice Address - Zip Code:89815-5126
Practice Address - Country:US
Practice Address - Phone:775-777-9355
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-27
Last Update Date:2009-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVRN52119364SM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes364SM0705XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistMedical-SurgicalGroup - Single Specialty