Provider Demographics
NPI:1861195356
Name:BEYOND THE HORIZON PRENATAL CARE CENTER
Entity type:Organization
Organization Name:BEYOND THE HORIZON PRENATAL CARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DOMANIKA
Authorized Official - Middle Name:J
Authorized Official - Last Name:WALTON
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:414-394-0793
Mailing Address - Street 1:5401 N 76TH ST STE 101
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53218-2746
Mailing Address - Country:US
Mailing Address - Phone:414-317-6435
Mailing Address - Fax:414-210-4302
Practice Address - Street 1:5401 N 76TH ST STE 101
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53218-2746
Practice Address - Country:US
Practice Address - Phone:414-317-6435
Practice Address - Fax:414-210-4302
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-23
Last Update Date:2023-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No261QB0400XAmbulatory Health Care FacilitiesClinic/CenterBirthing