MEDICARE: ASSURED HORIZONS LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency	100062900	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1386142610
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASSURED HORIZONS LLC

Provider Business Mailing Address
First Line	:	3910 W VERA AVE
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53209-2419
Country	:	US
Telephone Number	:	414-446-8309
Fax Number	:	832-383-3857

Provider Business Practice Location Address
First Line	:	3910 W VERA AVE
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53209-2419
Country	:	US
Telephone Number	:	414-446-8309
Fax Number	:	832-383-3857

Authorized Official
Title or Position	:	CEO
Name	:	MRS. KEYIA M HOLMES
Credential	:
Telephone Number	:	414-446-8309

Provider Enumeration Date	:	02/01/2018
Last Update Date	:	02/01/2018

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