Provider Demographics
NPI:1548528797
Name:COMMUNITY HORIZON, LLC
Entity type:Organization
Organization Name:COMMUNITY HORIZON, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:NESHANTA
Authorized Official - Middle Name:
Authorized Official - Last Name:WILBURN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-490-9559
Mailing Address - Street 1:3725 JAILETTE RD
Mailing Address - Street 2:
Mailing Address - City:COLLEGE PARK
Mailing Address - State:GA
Mailing Address - Zip Code:30349-1862
Mailing Address - Country:US
Mailing Address - Phone:770-490-9559
Mailing Address - Fax:404-766-1107
Practice Address - Street 1:544 MULBERRY ST
Practice Address - Street 2:SUITE 613
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31201-2770
Practice Address - Country:US
Practice Address - Phone:478-845-3015
Practice Address - Fax:478-845-3016
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-25
Last Update Date:2012-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA011-R-1025253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care