Healthcare Provider Details

I. General information

NPI: 1043725633
Provider Name (Legal Business Name): HORIZON HOME HEALTH CARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2017
Last Update Date: 12/09/2019
Certification Date: 12/09/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

677 N NEW BALLAS RD STE 221
CREVE COEUR MO
63141-6732
US

IV. Provider business mailing address

677 N NEW BALLAS RD STE 221
SAINT LOUIS MO
63141-6732
US

V. Phone/Fax

Practice location:
  • Phone: 314-801-7650
  • Fax:
Mailing address:
  • Phone: 314-753-0476
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code372500000X
TaxonomyChore Provider
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code171W00000X
TaxonomyContractor
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: ALINA MCCANN
Title or Position: OWNER
Credential:
Phone: 314-801-7650