NPIMap

Organization Active NPI

Horizon Health and Wellness, Inc.

  • Federally Qualified Health Center (FQHC)
  • Yuma, AZ
National Provider Identifier
1740859404
Registry record updated Jun 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
HORIZON HEALTH AND WELLNESS, INC.
Practice address
791 S 4TH Ave Ste B
Yuma, AZ 85364-3067
Phone
(480) 983-0065
NPI assigned
Jun 17, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2021

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

Authorized official

Name
Billie Holliday
Title
Chief Operating Officer
Phone
(480) 474-5580

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

791 S 4TH Ave Ste B
Yuma, AZ 85364-3067

Mailing address

625 N Plaza Dr
Apache Junction, AZ 85120-5502
Phone (480) 474-5580

Other names 1

  • horizon health and wellness Doing business as

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
O20220823000665 AZ Part A Provider - Federally Qualified Health Center (FQHC) 6406759711 Practice locations: Yuma, AZ

Federally qualified health center certification: CCN 031016

Legal name
HORIZON HEALTH AND WELLNESS, INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Aug 22, 2022
Last certification
Aug 22, 2022
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jun 25, 1986 in AZ
Enrollment address
1185 S Redondo Center Dr
Ste 1
Yuma, AZ 85365-2036

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
Tax ID family
San Pedro Valley Behavi32 organizations share this tax ID, including this one

Other organizations with this tax ID 31

Organizations that report the same tax identification number in the National Provider Directory.

View all 31

Locations

1185 S Redondo Center Dr
Ste 1
Yuma, AZ 85365
Phone (833) 431-4449

1185 S Redondo Center Dr
Yuma, AZ 85365

Ownership & related parties

All disclosed owners & managing parties 11

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 Corporate Director Oct 13, 2015
Benjamin Baxter Individual Corporate Officer Oct 1, 2019
William Joel Pearlman Individual Corporate Director Sep 12, 2018
Laura Larson-Huffaker Individual Corporate Officer Dec 17, 2018
Quindia Palmer Individual Corporate Director Sep 12, 2018
Robert Huddleston Individual Corporate Director Sep 12, 2018
Pamela Brotman Individual Corporate Officer Oct 1, 2019
Cassandra Corby Individual W-2 Managing Employee May 4, 2020
Raul Fiveash Individual Corporate Director Sep 12, 2018
Mike Farber Individual Corporate Director Sep 12, 2018
Brent Billingsley Individual Corporate Director Sep 12, 2018

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1623888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623888000000",
    "number": "1740859404",
    "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": "851205502",
            "telephone_number": "480-474-5580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "791 S 4TH AVE STE B",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853643067",
            "telephone_number": "480-983-0065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HORIZON HEALTH AND WELLNESS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-17",
        "last_updated": "2021-06-17",
        "certification_date": "2021-06-17",
        "status": "A",
        "authorized_official_last_name": "HOLLIDAY",
        "authorized_official_first_name": "BILLIE",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "480-474-5580"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "horizon health and wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Yuma, AZ

Sources for this page

Verify at the official NPI Registry.