# ACTIVE LIFE HOME CARE INC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** ACTIVE LIFE HOME CARE INC.
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1104398643
- **Legal business name:** ACTIVE LIFE HOME CARE INC.
- **Authorized official:** MR. ARIEL VALLADOLID CABRAL (ADMINISTRATOR)
- **Authorized official phone:** (310) 748-9390

## Contact information

- **Practice address:** 760 W. LOMITA BLVD., SUITE 79, HARBOR CITY, CA 90710
- **Practice address phone:** (310) 748-9390
- **Practice address fax:** (310) 847-6141
- **Mailing address:** 760 W. LOMITA BLVD., SUITE 79, HARBOR CITY, CA 90710
- **Mailing address phone:** (310) 748-9390
- **Mailing address fax:** (310) 847-6141

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 12/21/2018
- **Last updated:** 12/21/2018