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General NPI Number Information
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NPI Number | 1932524287
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Entity Type | Organization
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Legal Business Name | ACTIVE LIVING HOME HEALTH CARE, LLC
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Dates
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Enumeration Date | 02/24/2014
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Last Update Date | 02/24/2014
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Provider Practice Location Address
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Address Line | 24801 5 MILE RD SUITE 20
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City | REDFORD
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State | MI
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Zip | 48239-3655
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Country | US
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Telephone | 313-535-1838
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Fax | 313-255-5097
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Provider Business Mailing Address
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Address Line | 24801 5 MILE RD SUITE 20
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City | REDFORD
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State | MI
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Zip | 48239-3655
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Country | US
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Telephone | 313-535-1838
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Fax | 313-255-5097
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Authorized Official
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Title or Position | OWNER
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Name | MR. ANTHONY REDMOND
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Credential | ED.D, LMSW
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Telephone | 313-535-1838
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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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