Healthcare Provider Details

I. General information

NPI: 1932020658
Provider Name (Legal Business Name): OPEN HORIZONS HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2026
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

426 E COLLEGE ST
BOWDON GA
30108-1113
US

IV. Provider business mailing address

426 E COLLEGE ST
BOWDON GA
30108-1113
US

V. Phone/Fax

Practice location:
  • Phone: 847-252-1258
  • Fax:
Mailing address:
  • Phone: 847-252-1258
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: TARA DAVIS HOWELL
Title or Position: OWNER
Credential: MD
Phone: 847-252-1258