Healthcare Provider Details

I. General information

NPI: 1053747386
Provider Name (Legal Business Name): BEYOND THE HORIZONS HOME HEALTH CARE AGENCY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2013
Last Update Date: 01/02/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2645 FAIRWOOD AVE
COLUMBUS OH
43207-2729
US

IV. Provider business mailing address

4420 ORANGEBERRY DR
GROVE CITY OH
43123-7922
US

V. Phone/Fax

Practice location:
  • Phone: 608-630-0617
  • Fax:
Mailing address:
  • Phone: 608-630-0617
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320700000X
TaxonomyPhysical Disabilities Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: DR. WILLIAM C REYNOLDS
Title or Position: BISHOP
Credential:
Phone: 608-630-0617