=====================================================
General NPI Number Information
=====================================================
NPI Number | 1366507147
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HORIZON HILLS RESIDENTIAL GROUP CARE
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/22/2006
-----------------------------------------------------
Last Update Date | 07/21/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8115 MOHAWK LN
-----------------------------------------------------
City | RENO
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89506-9126
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 775-677-8115
-----------------------------------------------------
Fax | 775-677-4095
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8115 MOHAWK LN
-----------------------------------------------------
City | RENO
-----------------------------------------------------
State | NV
-----------------------------------------------------
Zip | 89506-9126
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 775-677-8115
-----------------------------------------------------
Fax | 775-677-4095
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ADMINISTRATOR
-----------------------------------------------------
Name | MR. WARLITO PIZARRO
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 775-750-0006
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 310400000X
-----------------------------------------------------
Taxonomy Name | Assisted Living Facility
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | NV
-----------------------------------------------------