Provider Demographics
NPI:1235587429
Name:HORIZON ASSISTED LIVING
Entity Type:Organization
Organization Name:HORIZON ASSISTED LIVING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TEJINDER
Authorized Official - Middle Name:SINGH
Authorized Official - Last Name:WALIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:386-301-4250
Mailing Address - Street 1:1571 N US HIGHWAY 1
Mailing Address - Street 2:
Mailing Address - City:ORMOND BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32174-8709
Mailing Address - Country:US
Mailing Address - Phone:386-301-4250
Mailing Address - Fax:386-301-4253
Practice Address - Street 1:1571 N US HIGHWAY 1
Practice Address - Street 2:
Practice Address - City:ORMOND BEACH
Practice Address - State:FL
Practice Address - Zip Code:32174-8709
Practice Address - Country:US
Practice Address - Phone:386-301-4250
Practice Address - Fax:386-301-4253
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-27
Last Update Date:2016-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAL12790310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility