Healthcare Provider Details

I. General information

NPI: 1326804915
Provider Name (Legal Business Name): HORIZON HEALTH AND WELLNESS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2024
Last Update Date: 02/27/2024
Certification Date: 02/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

702 E BELL RD STE 107
PHOENIX AZ
85022-6639
US

IV. Provider business mailing address

625 N PLAZA DR
APACHE JUNCTION AZ
85120-5502
US

V. Phone/Fax

Practice location:
  • Phone: 602-482-7311
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ELIZABETH RODRIGUEZ
Title or Position: DIRECTOR OF REVENUE CYCLE MGMT
Credential:
Phone: 520-876-1848