# A1 ACTIVE CARE

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

## Provider details

- **NPI number:** 1821491010
- **Authorized official:** MR. ANDREW M LACY SR. (MEMBER)
- **Authorized official phone:** (678) 230-7095

## Contact information

- **Practice address:** 1016 W JACKSON BLVD, CHICAGO, IL 60607-2914
- **Practice address phone:** (312) 675-8471
- **Practice address fax:** (312) 488-3648
- **Mailing address:** 1016 W JACKSON BLVD, CHICAGO, IL 60607-2914
- **Mailing address phone:** (312) 675-8471
- **Mailing address fax:** (312) 675-8471

## Taxonomy

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

## Other

- **Enumeration date:** 10/01/2014
- **Last updated:** 12/02/2016