Healthcare Provider Details

I. General information

NPI: 1235363904
Provider Name (Legal Business Name): HORIZON HEALTH AND SUBACUTE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2009
Last Update Date: 11/13/2020
Certification Date: 11/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3034 E HERNDON AVE
FRESNO CA
93720-0300
US

IV. Provider business mailing address

3034 E HERNDON AVE
FRESNO CA
93720-0300
US

V. Phone/Fax

Practice location:
  • Phone: 559-321-0883
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number040000076
License Number StateCA

VIII. Authorized Official

Name: MR. DONALD GORMLY JR.
Title or Position: CEO
Credential:
Phone: 209-357-3420