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NPI Code Detail

MEDICARE: HORIZON RIDGE CLINIC LLC

MEDICARE: HORIZON RIDGE CLINIC 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
1251B00000XCase Management Agency
2251B00000XCase Management AgencyNV
3251S00000XCommunity/Behavioral Health Agency
4251S00000XCommunity/Behavioral Health AgencyNV

Other Identifiers

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

General Provider Information

NPI Number : 1881003739
Entity Type Code : Organization
Provider Name (Legal Business Name) : HORIZON RIDGE CLINIC LLC
Provider Business Mailing Address
First Line : 1670 E FLAMINGO RD STE A
Second Line :
City : LAS VEGAS
State : NV
Zip : 89119-5120
Country : US
Telephone Number : 702-489-2889
Fax Number : 702-780-0755
Provider Business Practice Location Address
First Line : 1670 E FLAMINGO RD STE A
Second Line :
City : LAS VEGAS
State : NV
Zip : 89119-5120
Country : US
Telephone Number : 702-489-2889
Fax Number : 702-780-0755
Authorized Official
Title or Position : CHIEF ADMINISTRATOR
Name : BRUCE EDDINS
Credential : MA
Telephone Number : 702-489-2889
Provider Enumeration Date : 08/05/2014
Last Update Date : 02/12/2024

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Directions to “HORIZON RIDGE CLINIC LLC ” Practice Location

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