Basic Information
| Provider Information | |||||||||
| NPI: | 1417495003 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HORIZON PSYCHIATRY, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 21370 JOHN MILLESS DR | ||||||||
| Address2: | SUITE 210 | ||||||||
| City: | ROGERS | ||||||||
| State: | MN | ||||||||
| PostalCode: | 553749449 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7634282288 | ||||||||
| FaxNumber: | 7634282132 | ||||||||
| Practice Location | |||||||||
| Address1: | 21370 JOHN MILLESS DR | ||||||||
| Address2: | SUITE 210 | ||||||||
| City: | ROGERS | ||||||||
| State: | MN | ||||||||
| PostalCode: | 553749449 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7634282288 | ||||||||
| FaxNumber: | 7634282132 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/03/2017 | ||||||||
| LastUpdateDate: | 02/15/2017 | ||||||||
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| AuthorizedOfficialLastName: | ZINKEN | ||||||||
| AuthorizedOfficialFirstName: | THOMAS | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 7634282288 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QM0850X | Y | Ambulatory Health Care Facilities | Clinic/Center | Adult Mental Health |
No ID Information.