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General NPI Number Information
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NPI Number | 1063792067
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Entity Type | Organization
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Legal Business Name | HORIZON ADULT DAY HEALTH INC.
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Dates
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Enumeration Date | 08/22/2011
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Last Update Date | 08/22/2011
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Provider Practice Location Address
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Address Line | 4714 AUGUSTA RD
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City | GARDEN CITY
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State | GA
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Zip | 31408-1727
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Country | US
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Telephone | 912-658-4804
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Fax |
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Provider Business Mailing Address
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Address Line | 702 PLANTATION DR
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City | RINCON
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State | GA
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Zip | 31326-9708
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Country | US
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Telephone | 912-658-4804
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Fax |
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Authorized Official
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Title or Position | CENTER DIRECTOR/OWNER
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Name | MS. LUCY ANGULU OSUNDWA
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Credential |
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Telephone | 912-658-4804
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State |
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