Provider Demographics
NPI:1538597364
Name:HORIZON ADULT AND SENIOR CARE LLC
Entity type:Organization
Organization Name:HORIZON ADULT AND SENIOR CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ATCHUTHA
Authorized Official - Middle Name:GEETHA
Authorized Official - Last Name:CHILAKAMARRI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:240-393-6880
Mailing Address - Street 1:13045 WOODCUTTER CIR
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20876-6958
Mailing Address - Country:US
Mailing Address - Phone:240-393-6880
Mailing Address - Fax:
Practice Address - Street 1:9801 GEORGIA AVE
Practice Address - Street 2:SUITE 277
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20902-5276
Practice Address - Country:US
Practice Address - Phone:240-393-6880
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-14
Last Update Date:2013-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0069568207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Single Specialty