Provider Demographics
NPI:1457432676
Name:HORIZON HOME HEALTH, LC
Entity Type:Organization
Organization Name:HORIZON HOME HEALTH, LC
Other - Org Name:HORIZON HOME HEALTH OF PHOENIX
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPERATING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:BENSON
Authorized Official - Last Name:WOOLLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:801-225-7171
Mailing Address - Street 1:11 E 200 N
Mailing Address - Street 2:
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84057-4764
Mailing Address - Country:US
Mailing Address - Phone:801-225-7171
Mailing Address - Fax:801-225-7977
Practice Address - Street 1:2720 E THOMAS RD STE 270B
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-8232
Practice Address - Country:US
Practice Address - Phone:480-894-5113
Practice Address - Fax:480-894-5134
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-17
Last Update Date:2022-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZHHA3642251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAZ0703970OtherBLUE CROSS
AZ957730Medicaid
AZ037233Medicare ID - Type Unspecified