Healthcare Provider Details

I. General information

NPI: 1063010429
Provider Name (Legal Business Name): HORIZON HOME HEALTH CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/16/2020
Last Update Date: 10/16/2020
Certification Date: 10/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 W VIRGINIA AVE STE 200C
PINEVILLE KY
40977-1662
US

IV. Provider business mailing address

121 W VIRGINIA AVE STE 200C
PINEVILLE KY
40977-1662
US

V. Phone/Fax

Practice location:
  • Phone: 859-623-4080
  • Fax: 859-624-5771
Mailing address:
  • Phone: 859-623-4080
  • Fax: 859-624-5771

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MARIBETH UPCHURCH
Title or Position: OPERATIONS ASSOCIATE
Credential:
Phone: 859-623-4080