Healthcare Provider Details

I. General information

NPI: 1417811373
Provider Name (Legal Business Name): AMERICAS ACTIVE SOLUTION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 MAIN ST STE 101
PAWTUCKET RI
02860-4047
US

IV. Provider business mailing address

100 PARK PL APT 105
PAWTUCKET RI
02860-4083
US

V. Phone/Fax

Practice location:
  • Phone: 401-442-3638
  • Fax:
Mailing address:
  • Phone: 401-442-3638
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State

VIII. Authorized Official

Name: CAROL JOSEPHINE FERRER
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 786-999-9656