Organization Name: | PRIME HORIZON, INC. |
NPI Number: | 1033553946 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | SHAWN PATRICK MILES (DIRECTOR) |
Mailing Address: | 117 N Milwaukee St Port Washington |
State: | WI US |
Postal Code: | 530741819 |
Phone Number: | 2622849656 |
Fax Number: | 2622844590 |
NPI Enumeration Date: | 04/22/2013 |
NPI Last Update Date: | 04/22/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 253Z00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WI |
Taxonomy Type: | Agencies |
Taxonomy Classification: | In Home Supportive Care |
Taxonomy Specialization: | |
Taxonomy Definition: | An In Home Supportive Care Agency provides services in the patient |