Healthcare Provider Details

I. General information

NPI: 1003309238
Provider Name (Legal Business Name): HORIZON HEALTH AND WELLNESS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2018
Last Update Date: 06/01/2023
Certification Date: 06/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

495 N PINAL PKWY STE 106
FLORENCE AZ
85132-8870
US

IV. Provider business mailing address

625 N PLAZA DR
APACHE JUNCTION AZ
85120-5501
US

V. Phone/Fax

Practice location:
  • Phone: 480-983-0065
  • Fax:
Mailing address:
  • Phone: 480-983-0065
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License NumberOTC8980
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License NumberBH5457
License Number StateAZ

VIII. Authorized Official

Name: ELIZABETH RODRIGUEZ
Title or Position: ASSISTANT CFO
Credential:
Phone: 520-876-1848