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General NPI Number Information
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NPI Number | 1558541144
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Entity Type | Organization
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Legal Business Name | ACTIVE HOME HEALTH CARE SERVICES,LLC
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Dates
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Enumeration Date | 11/12/2007
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Last Update Date | 06/28/2023
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Provider Practice Location Address
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Address Line | 5589 OKEECHOBEE BLVD STE 105
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City | WEST PALM BEACH
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State | FL
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Zip | 33417-4486
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Country | US
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Telephone | 561-968-5553
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Fax | 561-300-2115
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Provider Business Mailing Address
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Address Line | 5589 OKEECHOBEE BLVD STE 105
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City | WEST PALM BEACH
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State | FL
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Zip | 33417-4486
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Country | US
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Telephone | 561-968-5553
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Fax | 561-300-2115
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Authorized Official
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Title or Position | CEO
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Name | MR. CONRAD ZAGUIRRE
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Credential |
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Telephone | 561-968-5553
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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 | 299992941
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License Number State | FL
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