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NPI Code Detail

MEDICARE: ACTIVA HEALTH SERVICES, INC.

MEDICARE: ACTIVA HEALTH SERVICES, 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
1251E00000XHome Health AgencyHHA299991980FL
2251E00000XHome Health AgencyHHA299991942FL

General Provider Information

NPI Number : 1376549675
Entity Type Code : Organization
Provider Name (Legal Business Name) : ACTIVA HEALTH SERVICES, INC.
Provider Business Mailing Address
First Line : 1165 NORTHCHASE PKWY SE STE 250
Second Line :
City : MARIETTA
State : GA
Zip : 30067-6432
Country : US
Telephone Number : 470-421-0191
Fax Number : 561-207-7843
Provider Business Practice Location Address
First Line : 7451 WILES RD STE 207
Second Line :
City : CORAL SPRINGS
State : FL
Zip : 33067-2040
Country : US
Telephone Number : 954-900-1110
Fax Number : 954-382-0377
Authorized Official
Title or Position : SVP OF COMPLIANCE
Name : MARCELLA LYNCH
Credential :
Telephone Number : 470-392-9412
Provider Enumeration Date : 06/22/2005
Last Update Date : 06/20/2024

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Directions to “ACTIVA HEALTH SERVICES, INC. ” Practice Location

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