Provider Demographics
NPI:1063730208
Name:UNICORN VENTURES LLC
Entity type:Organization
Organization Name:UNICORN VENTURES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:
Authorized Official - Last Name:AGUILAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-655-4616
Mailing Address - Street 1:9891 GOODLUCK ROAD #9
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706
Mailing Address - Country:US
Mailing Address - Phone:301-655-4616
Mailing Address - Fax:
Practice Address - Street 1:9891 GOOD LUCK RD APT 9
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-3239
Practice Address - Country:US
Practice Address - Phone:301-655-4616
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-12
Last Update Date:2010-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization