# ACTIVE HOME CARE INC.

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

## Provider details

- **NPI number:** 1174935134
- **Authorized official:** MR. JUSTIN CODY WILLIS (PRESIDENT)
- **Authorized official phone:** (941) 564-8621

## Contact information

- **Practice address:** 2565 N TOLEDO BLADE BLVD, NORTH PORT, FL 34289-9306
- **Practice address phone:** (941) 564-8621
- **Practice address fax:** (941) 429-3322
- **Mailing address:** 2565 N TOLEDO BLADE BLVD, NORTH PORT, FL 34289-9306
- **Mailing address phone:** (941) 564-8621
- **Mailing address fax:** (941) 429-3322

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 05/27/2014
- **Last updated:** 05/27/2014