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General NPI Number Information
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NPI Number | 1801185301
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Entity Type | Organization
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Legal Business Name | HORIZON SENIOR CARE INC
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Dates
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Enumeration Date | 04/05/2011
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Last Update Date | 06/24/2011
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Provider Practice Location Address
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Address Line | 229 BRADFIELD LN
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City | ROCKWALL
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State | TX
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Zip | 75087-9272
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Country | US
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Telephone | 972-839-6099
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Fax |
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Provider Business Mailing Address
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Address Line | 229 BRADFIELD LN
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City | ROCKWALL
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State | TX
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Zip | 75087-9272
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Country | US
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Telephone | 972-839-6099
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. AMBER S STASIAK
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Credential | PA-C
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Telephone | 972-839-6099
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 364SP0808X
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Taxonomy Name | Psychiatric/Mental Health Clinical Nurse Specialist
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License Number | PA00801
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License Number State | TX
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