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Organization
ACTIVE 360 THERAPY
Active
Organization
ACTIVE 360 THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CALISTA CHANA (CEO)
(301) 776-8103
Entity
Organization
Contact information
Practice address
6212 YORK RD, BALTIMORE, MD 21212-2612
(301) 776-8103
(410) 755-7797
Mailing address
6801 OAK HALL LN UNIT 6462, COLUMBIA, MD 21045-7587
(301) 776-8103
(410) 755-7797
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
NULL
104100000X
Social Worker
—
—
163WH0200X
Home Health Registered Nurse
—
NULL
163WH0200X
Home Health Registered Nurse
—
—
225100000X
Physical Therapist
Primary
—
NULL
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
NULL
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
NULL
235Z00000X
Speech-Language Pathologist
—
—
251E00000X
Home Health Agency
—
NULL
Other
Enumeration date
12/02/2024
Last updated
10/10/2025
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