Provider Demographics
NPI:1669123360
Name:HORIZON WELLNESS LLC
Entity type:Organization
Organization Name:HORIZON WELLNESS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NKIRU
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:301-383-6834
Mailing Address - Street 1:1215 ANNAPOLIS RD STE 101
Mailing Address - Street 2:
Mailing Address - City:ODENTON
Mailing Address - State:MD
Mailing Address - Zip Code:21113-1334
Mailing Address - Country:US
Mailing Address - Phone:410-220-4449
Mailing Address - Fax:301-576-5715
Practice Address - Street 1:1215 ANNAPOLIS RD STE 101
Practice Address - Street 2:
Practice Address - City:ODENTON
Practice Address - State:MD
Practice Address - Zip Code:21113-1334
Practice Address - Country:US
Practice Address - Phone:410-220-4449
Practice Address - Fax:301-576-5715
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HORIZON HEALTH SERVICES LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-01-13
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)