NPIMap

Organization Active NPI

Horizon Health and Wellness, Inc.

  • Federally Qualified Health Center (FQHC)
  • Florence, AZ
National Provider Identifier
1003309238
Registry record updated Jun 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
OTC8980 Issued in AZ
Legal business name
HORIZON HEALTH AND WELLNESS, INC.
Practice address
495 N Pinal Pkwy Ste 106
Florence, AZ 85132-8870
Phone
(480) 983-0065
NPI assigned
Jun 12, 2018
Last updated
Jun 1, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Elizabeth Rodriguez
Title
Assistant Cfo
Phone
(520) 876-1848

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X OTC8980 AZ Primary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X BH5457 AZ

Addresses

Primary practice location

495 N Pinal Pkwy Ste 106
Florence, AZ 85132-8870

Mailing address

625 N Plaza Dr
Apache Junction, AZ 85120-5501
Phone (480) 983-0065

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040202000450 AZ Part B Supplier - Clinic/Group Practice 6406759711 Receives reassigned benefits from 93 practitioners
37 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Queen Creek, AZ; Yuma, AZ; Oracle, AZ; Globe, AZ; Casa Grande, AZ; Florence, AZ; Apache Junction, AZ
O20240103002263 AZ Part A Provider - Federally Qualified Health Center (FQHC) 6406759711 Practice locations: Florence, AZ

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1003309238. Details of each certification follow.

Federally qualified health center certification: CCN 031028

Legal name
HORIZON HEALTH AND WELLNESS, INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Dec 27, 2023
Last certification
Dec 27, 2023
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Sep 1, 2015 in AZ
Enrollment address
495 N Pinal Pkwy
Ste 106
Florence, AZ 85132-8870

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 18

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 18

National Provider Directory

National Provider Directory

Locations

495 N Pinal Pkwy
Ste 1
Florence, AZ 85132

495 N Pinal Pkwy
Ste 106
Florence, AZ 85132
Phone (520) 568-0573

Ownership & related parties

All disclosed owners & managing parties 5

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Elizabeth Rodriguez Individual W-2 Managing EmployeeDirector of Revenue Cycle Mar 24, 1994
Benjamin Baxter Individual Corporate OfficerChief Financial Officer Feb 28, 2019
Raul Fiveash Individual Corporate OfficerBoard of Directors Vice Chair Apr 1, 2016
Mike Farber Individual Corporate OfficerBoard of Directors Vice Chair Apr 1, 2019
Brent Billingsley Individual Corporate OfficerBoard of Directors Vice Chair Oct 1, 2015

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1528761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685577600000",
    "number": "1003309238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 N PLAZA DR",
            "city": "APACHE JUNCTION",
            "state": "AZ",
            "postal_code": "851205501",
            "telephone_number": "480-983-0065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "495 N PINAL PKWY STE 106",
            "city": "FLORENCE",
            "state": "AZ",
            "postal_code": "851328870",
            "telephone_number": "480-983-0065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HORIZON HEALTH AND WELLNESS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-12",
        "last_updated": "2023-06-01",
        "certification_date": "2023-06-01",
        "status": "A",
        "authorized_official_last_name": "RODRIGUEZ",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "ASSISTANT CFO",
        "authorized_official_telephone_number": "520-876-1848"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "AZ",
            "license": "OTC8980",
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "AZ",
            "license": "BH5457",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Florence, AZ

Sources for this page

Verify at the official NPI Registry.