Provider Demographics
NPI:1366270670
Name:HORIZON HEALTHCARE OF NEW MEXICO INC
Entity type:Organization
Organization Name:HORIZON HEALTHCARE OF NEW MEXICO INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KARL
Authorized Official - Middle Name:
Authorized Official - Last Name:RAJANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-581-0582
Mailing Address - Street 1:217 WISCONSIN AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:WAUKESHA
Mailing Address - State:WI
Mailing Address - Zip Code:53186-4946
Mailing Address - Country:US
Mailing Address - Phone:414-376-5577
Mailing Address - Fax:414-762-9927
Practice Address - Street 1:1209 MOUNTAIN ROAD PL NE STE R
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-7845
Practice Address - Country:US
Practice Address - Phone:414-376-5577
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-26
Last Update Date:2024-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty