# ACTIVE ADULTS PROGRAM LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1093685133
- **Authorized official:** ESTREANDA FULFORD (CEO)
- **Authorized official phone:** (619) 908-2643

## Contact information

- **Practice address:** 7940 SILVERTON AVE STE 204, SAN DIEGO, CA 92126-6341
- **Practice address phone:** (619) 908-2643
- **Mailing address:** 11475 HADAR DR, SAN DIEGO, CA 92126-1361
- **Mailing address phone:** (619) 908-2643

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251B00000X | Case Management Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 11/05/2025
- **Last updated:** 11/05/2025