MEDICARE: THOREAUSA HORNE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	172V00000X	Community Health Worker
2	372500000X	Chore Provider
3	372600000X	Adult Companion
4	373H00000X	Day Training/Habilitation Specialist
5	3747A0650X	Attendant Care Provider
6	3747P1801X	Personal Care Attendant
7	376J00000X	Homemaker
8	376K00000X	Nurse's Aide

General Provider Information

NPI Number	:	1205201167
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THOREAUSA HORNE

Provider Business Mailing Address
First Line	:	110 RED LIGHT RD
Second Line	:
City	:	BRANDON
State	:	MS
Zip	:	39042-9492
Country	:	US
Telephone Number	:	601-940-3825
Fax Number	:

Provider Business Practice Location Address
First Line	:	110 RED LIGHT RD
Second Line	:
City	:	BRANDON
State	:	MS
Zip	:	39042-9492
Country	:	US
Telephone Number	:	601-940-3825
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/03/2015
Last Update Date	:	12/03/2015

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Directions to “ THOREAUSA HORNE ” Practice Location

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