Healthcare Provider Details

I. General information

NPI: 1962377705
Provider Name (Legal Business Name): HORIZONS HEALTHCARE HOSPICE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2025
Last Update Date: 10/10/2025
Certification Date: 10/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11351 RANDOM HILLS RD # 220
FAIRFAX VA
22030-6081
US

IV. Provider business mailing address

5511 LAVATERA CT
CENTREVILLE VA
20120-2705
US

V. Phone/Fax

Practice location:
  • Phone: 703-537-0107
  • Fax:
Mailing address:
  • Phone: 646-338-8056
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State

VIII. Authorized Official

Name: DENNIS CORTEZ
Title or Position: MANAGING MEMBER
Credential: PT
Phone: 646-338-8056