MEDICARE: ACTIVE HOME CARE INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1174935134
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ACTIVE HOME CARE INC.

Provider Business Mailing Address
First Line	:	2565 N TOLEDO BLADE BLVD
Second Line	:
City	:	NORTH PORT
State	:	FL
Zip	:	34289-9306
Country	:	US
Telephone Number	:	941-564-8621
Fax Number	:	941-429-3322

Provider Business Practice Location Address
First Line	:	2565 N TOLEDO BLADE BLVD
Second Line	:
City	:	NORTH PORT
State	:	FL
Zip	:	34289-9306
Country	:	US
Telephone Number	:	941-564-8621
Fax Number	:	941-429-3322

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. JUSTIN CODY WILLIS
Credential	:
Telephone Number	:	941-564-8621

Provider Enumeration Date	:	05/27/2014
Last Update Date	:	05/27/2014

Similar Medicare Providers

1578698346 — DANIELA SODRE
Practice Location Address:

2565 N TOLEDO BLADE BLVD
NORTH PORT, FL
34289-9306

Practice Phone: 800-892-0640
Practice Fax:

1326340555 — KEYUR PATEL D.O.
Practice Location Address:

2565 N TOLEDO BLADE BLVD UNIT 3
NORTH PORT, FL
34289-9306

Practice Phone: 215-307-2355
Practice Fax:

1174941645 — NILAMBEN PATEL DO
Practice Location Address:

2565 N TOLEDO BLADE BLVD
NORTH PORT, FL
34289-9306

Practice Phone: 941-257-3119
Practice Fax: 941-485-6408

1487023602 — HEAVENLY HEARTS SERVICES LLC
Practice Location Address:

2565 N TOLEDO BLADE BLVD , UNIT 1
NORTH PORT, FL
34289-9306

Practice Phone: 941-525-8945
Practice Fax:

1750738746 — STACEY SANTAGATA BCBA
Practice Location Address:

2565 N TOLEDO BLADE BLVD
NORTH PORT, FL
34289-9306

Practice Phone: 941-416-4338
Practice Fax:

1033608039 — MAKAYLA FRANCIS
Practice Location Address:

2565 N TOLEDO BLADE BLVD
NORTH PORT, FL
34289-9306

Practice Phone: 941-485-0121
Practice Fax:

Directions to “ACTIVE HOME CARE INC. ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.