Organization
HORIZON HEALTHCARE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DARREN MATAVKA (VICE PRESIDENT)
(414) 376-5577
Entity
Organization
Contact information
Practice address
800 GOOLD ST, RACINE, WI 53402-4567
(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
2084P0800X
Psychiatry Physician
—
—
208D00000X
General Practice Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
122505
—
WI
Enumeration date
02/13/2015
Last updated
02/13/2015
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