Healthcare Provider Details
I. General information
NPI: 1063792067
Provider Name (Legal Business Name): HORIZON ADULT DAY HEALTH INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/22/2011
Last Update Date: 08/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4714 AUGUSTA RD
GARDEN CITY GA
31408-1727
US
IV. Provider business mailing address
702 PLANTATION DR
RINCON GA
31326-9708
US
V. Phone/Fax
- Phone: 912-658-4804
- Fax:
- Phone: 912-658-4804
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QA0600X |
| Taxonomy | Adult Day Care Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MS.
LUCY
ANGULU
OSUNDWA
Title or Position: CENTER DIRECTOR/OWNER
Credential:
Phone: 912-658-4804