Provider Demographics
NPI:1871101196
Name:GREAT HORIZONS LLC
Entity type:Organization
Organization Name:GREAT HORIZONS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO/MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:TERRENCE
Authorized Official - Middle Name:
Authorized Official - Last Name:LOVELESS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-526-8036
Mailing Address - Street 1:17127 PIONEER BLVD STE S
Mailing Address - Street 2:
Mailing Address - City:ARTESIA
Mailing Address - State:CA
Mailing Address - Zip Code:90701-2757
Mailing Address - Country:US
Mailing Address - Phone:562-526-8036
Mailing Address - Fax:562-526-8027
Practice Address - Street 1:17127 PIONEER BLVD STE S
Practice Address - Street 2:
Practice Address - City:ARTESIA
Practice Address - State:CA
Practice Address - Zip Code:90701-2757
Practice Address - Country:US
Practice Address - Phone:562-526-8036
Practice Address - Fax:562-526-8027
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-22
Last Update Date:2022-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive CareGroup - Single Specialty
No310400000XNursing & Custodial Care FacilitiesAssisted Living FacilityGroup - Single Specialty
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty