Healthcare Provider Details

I. General information

NPI: 1598731648
Provider Name (Legal Business Name): HORIZON HEALTH CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/28/2006
Last Update Date: 02/09/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 W MAIN ST.
BISON SD
57620-0427
US

IV. Provider business mailing address

PO BOX 427
BISON SD
57620-0427
US

V. Phone/Fax

Practice location:
  • Phone: 605-244-5206
  • Fax: 605-244-5208
Mailing address:
  • Phone: 605-244-5206
  • Fax: 605-244-5208

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier5350300
Identifier TypeMEDICAID
Identifier StateSD
Identifier Issuer
# 2
Identifier42509
Identifier TypeOTHER
Identifier State
Identifier IssuerMED B GROUP

VIII. Authorized Official

Name: JOHN MENGENHAUSEN
Title or Position: AUTHORIZED OFFICIAL CEO
Credential: CEO
Phone: 605-772-4525