# ACTIVE LIFE THERAPIES LLC

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

## Provider details

- **NPI number:** 1851830046
- **Authorized official:** MR. JEFFREY O DANN (OWNER/CEO)
- **Authorized official phone:** (716) 510-2470

## Contact information

- **Practice address:** 2776 DELAWARE AVE, KENMORE, NY 14217-2740
- **Practice address phone:** (716) 332-0404
- **Practice address fax:** (716) 871-1998
- **Mailing address:** 2776 DELAWARE AVE, KENMORE, NY 14217-2740
- **Mailing address phone:** (716) 332-0404
- **Mailing address fax:** (716) 871-1998

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR0401X | Comprehensive Outpatient Rehabilitation Facility (CORF) | — | NULL | Yes |

## Other

- **Enumeration date:** 02/21/2017
- **Last updated:** 02/21/2017