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Organization
ACTIVE HEALTH SERVICES, INC
Active
Organization
ACTIVE HEALTH SERVICES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SHADRACK JORAM BAMPEBUYE (CEO)
(202) 763-2290
Entity
Organization
Contact information
Practice address
2915 RHODE ISLAND AVE NE, WASHINGTON, DC 20018-2943
(202) 763-2290
Mailing address
5722 LITTLE SPRING WAY, FREDERICK, MD 21704-6704
(202) 763-2290
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
172V00000X
Community Health Worker
—
—
251E00000X
Home Health Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
3245S0500X
Children's Substance Abuse Rehabilitation Facility
—
—
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
—
—
Other
Enumeration date
10/28/2022
Last updated
10/28/2022
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