# ACTIVA HOME HEALTHCARE LLC

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

## Provider details

- **NPI number:** 1821799883
- **Authorized official:** ROSELLE OSTENDORF (PRESIDENT/ADMIN)
- **Authorized official phone:** (505) 362-7977

## Contact information

- **Practice address:** 2900 LOUISIANA BLVD NE STE B1, ALBUQUERQUE, NM 87110-3564
- **Practice address phone:** (505) 362-7977
- **Mailing address:** PO BOX 11099, ALBUQUERQUE, NM 87192-0099
- **Mailing address phone:** (505) 362-7977

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 253Z00000X | In Home Supportive Care Agency | — | — | Yes |
| 3747P1801X | Personal Care Attendant | — | — | — |

## Other

- **Enumeration date:** 03/15/2023
- **Last updated:** 08/02/2023