Organization
PRIME HORIZON, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SHAWN PATRICK MILES (DIRECTOR)
(262) 284-9656
Entity
Organization
Contact information
Practice address
117 N MILWAUKEE ST, PORT WASHINGTON, WI 53074-1819
(262) 284-9656
(262) 284-4590
Mailing address
117 N MILWAUKEE ST, PORT WASHINGTON, WI 53074-1819
(262) 284-9656
(262) 284-4590
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
WI
Other
Enumeration date
04/22/2013
Last updated
04/22/2013
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