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General NPI Number Information
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NPI Number | 1932149622
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Entity Type | Organization
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Legal Business Name | HORIZON HEALTHCARE CENTER LLC
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Dates
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Enumeration Date | 06/08/2006
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Last Update Date | 09/02/2021
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Provider Practice Location Address
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Address Line | 2628 WILHITE CT
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City | LEXINGTON
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State | KY
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Zip | 40503-3327
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Country | US
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Telephone | 859-303-8746
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Fax |
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Provider Business Mailing Address
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Address Line | 1031 WELLINGTON WAY STE 240
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City | LEXINGTON
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State | KY
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Zip | 40513-1257
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Country | US
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Telephone | 859-303-8746
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Fax |
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Authorized Official
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Title or Position | CREDENTIALING AGENT
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Name | BRITTANY UNDERWOOD
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Credential |
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Telephone | 859-303-8746
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 16524
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | 17681
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License Number State | KY
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Taxonomy #4
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 700122
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License Number State | KY
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Taxonomy #5
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State | KY
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