=====================================================
General NPI Number Information
=====================================================
NPI Number | 1558891150
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HORIZON PRIMARY HOME CARE,INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/15/2017
-----------------------------------------------------
Last Update Date | 07/21/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 556 W. ELIZABETH ST. STE A
-----------------------------------------------------
City | BROWNSVILLE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78520
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 956-579-4776
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 556 W ELIZABETH ST STE A
-----------------------------------------------------
City | BROWNSVILLE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78520-6389
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 956-579-4776
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | LIDIA BEATRIZ PEREZ
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 956-579-4776
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 253Z00000X
-----------------------------------------------------
Taxonomy Name | In Home Supportive Care Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------