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General NPI Number Information
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NPI Number | 1861889982
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Entity Type | Organization
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Legal Business Name | ACTIVE HOME HEALTH CARE, INC.
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Dates
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Enumeration Date | 04/16/2015
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Last Update Date | 04/16/2015
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Provider Practice Location Address
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Address Line | 150 FELKER ST STE B
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City | SANTA CRUZ
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State | CA
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Zip | 95060-2849
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Country | US
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Telephone | 888-361-7648
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2221
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City | APTOS
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State | CA
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Zip | 95001-2221
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Country | US
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Telephone | 831-435-8403
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Fax |
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Authorized Official
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Title or Position | VICE-PRESIDENT
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Name | MS. CANDI L WOOD
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Credential |
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Telephone | 831-435-8403
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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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