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General NPI Number Information
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NPI Number | 1508651498
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Entity Type | Organization
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Legal Business Name | ACTIVE SC ONE, INC.
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Dates
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Enumeration Date | 04/11/2025
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Last Update Date | 05/13/2025
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Provider Practice Location Address
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Address Line | 4727C SUNSET BLVD
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City | LEXINGTON
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State | SC
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Zip | 29072-9151
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Country | US
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Telephone | 803-951-0771
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Fax |
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Provider Business Mailing Address
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Address Line | 6 INTERPLEX DR STE 401
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City | TREVOSE
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State | PA
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Zip | 19053-6942
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Country | US
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Telephone | 215-642-6600
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Fax |
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Authorized Official
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Title or Position | REGULATORY & CONTRACT ANALYST
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Name | STEPHANIE VANSCHAICK
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Credential |
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Telephone | 215-642-6600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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