Healthcare Provider Details

I. General information

NPI: 1174699987
Provider Name (Legal Business Name): HORIZONS RESIDENTIAL CARE CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/27/2006
Last Update Date: 07/23/2020
Certification Date: 07/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 HORIZONS LANE
RURAL HALL NC
27045-9819
US

IV. Provider business mailing address

103 HORIZONS LN
RURAL HALL NC
27045-9819
US

V. Phone/Fax

Practice location:
  • Phone: 336-837-2072
  • Fax: 336-661-2185
Mailing address:
  • Phone: 336-837-2072
  • Fax: 336-661-2185

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License NumberMHL-034-016
License Number StateNC

VIII. Authorized Official

Name: RICHARD ALAN ANDERSON
Title or Position: PRESIDENT & CEO
Credential:
Phone: 336-837-2072