Healthcare Provider Details

I. General information

NPI: 1821944745
Provider Name (Legal Business Name): LIV ACTIVE A.D.H.C. LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/05/2026
Last Update Date: 03/05/2026
Certification Date: 03/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

36 5TH ST
FALL RIVER MA
02721-2846
US

IV. Provider business mailing address

36 5TH ST
FALL RIVER MA
02721-2846
US

V. Phone/Fax

Practice location:
  • Phone: 508-567-1130
  • Fax: 774-704-5847
Mailing address:
  • Phone: 508-567-1130
  • Fax: 774-704-5847

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ZACHARY TESLER
Title or Position: PROGRAM DIRECTOR
Credential:
Phone: 617-839-8300