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General NPI Number Information
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NPI Number | 1770191926
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Entity Type | Organization
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Legal Business Name | ACTIVE HOME HEALTH CARE LLC
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Dates
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Enumeration Date | 07/14/2020
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Last Update Date | 07/14/2020
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Provider Practice Location Address
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Address Line | 4848 S 76TH ST STE 200A
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City | GREENFIELD
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State | WI
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Zip | 53220-4361
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Country | US
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Telephone | 414-209-2866
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Fax |
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Provider Business Mailing Address
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Address Line | 4848 S 76TH ST STE 200A
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City | GREENFIELD
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State | WI
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Zip | 53220-4361
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Country | US
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Telephone | 414-209-2866
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | SHAFI HOSEEN
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Credential |
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Telephone | 414-209-2866
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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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