Organization
HORIZON HEALTHCARE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DARREN MATAVKA (EXECUTIVE VICE PRESIDENT)
(414) 301-6383
Entity
Organization
Contact information
Practice address
724 ELM ST, WEST BEND, WI 53095-3205
(414) 376-5577
(414) 376-5577
Mailing address
4650 S HOWELL AVE, MILWAUKEE, WI 53207-5906
(414) 376-5577
(414) 376-5577
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
—
363LA2200X
Adult Health Nurse Practitioner
—
—
Other
Enumeration date
12/11/2014
Last updated
12/11/2014
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