Provider Demographics
NPI:1124744644
Name:HORIZON CARE LLC
Entity type:Organization
Organization Name:HORIZON CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANESSA
Authorized Official - Middle Name:
Authorized Official - Last Name:CANIDATE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:850-321-6343
Mailing Address - Street 1:925 ARLINGTON CIRLCLE
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:FL
Mailing Address - Zip Code:32351
Mailing Address - Country:US
Mailing Address - Phone:850-321-6343
Mailing Address - Fax:850-662-4988
Practice Address - Street 1:1147 MARTIN LUTHER KING BLVD
Practice Address - Street 2:QUINCY
Practice Address - City:QUINCY
Practice Address - State:FL
Practice Address - Zip Code:32351
Practice Address - Country:US
Practice Address - Phone:850-321-6343
Practice Address - Fax:850-662-4988
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-17
Last Update Date:2022-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172V00000XOther Service ProvidersCommunity Health WorkerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL688704096Medicaid