Provider Demographics
NPI:1346915808
Name:HORTON, RALPH FRANKLIN II
Entity type:Individual
Prefix:
First Name:RALPH
Middle Name:FRANKLIN
Last Name:HORTON
Suffix:II
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3303 AILSA AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21214-2906
Mailing Address - Country:US
Mailing Address - Phone:301-613-3912
Mailing Address - Fax:
Practice Address - Street 1:3303 AILSA AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21214-2906
Practice Address - Country:US
Practice Address - Phone:301-613-3912
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-16
Last Update Date:2021-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD30AL3959310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility