Healthcare Provider Details

I. General information

NPI: 1912011941
Provider Name (Legal Business Name): HORIZON HEALTH CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2006
Last Update Date: 06/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 3RD STREET SW
DESMET SD
57231
US

IV. Provider business mailing address

801 3RD STREET SW
DESMET SD
57231
US

V. Phone/Fax

Practice location:
  • Phone: 605-854-3444
  • Fax:
Mailing address:
  • Phone: 605-854-3444
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

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