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General NPI Number Information
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NPI Number | 1871101196
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Entity Type | Organization
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Legal Business Name | GREAT HORIZONS LLC
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Dates
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Enumeration Date | 07/22/2020
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Last Update Date | 03/27/2022
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Provider Practice Location Address
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Address Line | 17127 PIONEER BLVD STE S
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City | ARTESIA
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State | CA
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Zip | 90701-2757
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Country | US
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Telephone | 562-526-8036
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Fax | 562-526-8027
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Provider Business Mailing Address
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Address Line | 17127 PIONEER BLVD STE S
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City | ARTESIA
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State | CA
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Zip | 90701-2757
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Country | US
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Telephone | 562-526-8036
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Fax | 562-526-8027
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Authorized Official
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Title or Position | CEO/MANAGER
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Name | MR. TERRENCE LOVELESS
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Credential |
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Telephone | 562-526-8036
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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