# ACTIVECARE PROVIDER SERVICES

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

## Provider details

- **NPI number:** 1538603311
- **Authorized official:** SAMUEL PREVOST (ADMINISTRATOR)
- **Authorized official phone:** (346) 319-0229

## Contact information

- **Practice address:** 8700 COMMERCE PARK DR STE 218-B, HOUSTON, TX 77036-7497
- **Practice address phone:** (346) 319-0229
- **Mailing address:** 8700 COMMERCE PARK DR STE 218-B, HOUSTON, TX 77036-7497
- **Mailing address phone:** (346) 319-0229

## Taxonomy

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

## Other

- **Enumeration date:** 12/13/2016
- **Last updated:** 12/14/2018