# ACTIVE HOME CARE

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

## Provider details

- **NPI number:** 1891986113
- **Authorized official:** MR. ROBERT W BAYSDON (OWNER)
- **Authorized official phone:** (910) 671-0299

## Contact information

- **Practice address:** 2201 N PINE ST STE C, LUMBERTON, NC 28358
- **Practice address phone:** (910) 671-0299
- **Practice address fax:** (910) 671-1983
- **Mailing address:** PO BOX 747, LUMBERTON, NC 28359-0747
- **Mailing address phone:** (910) 671-0299
- **Mailing address fax:** (910) 671-1983

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 311ZA0620X | Adult Care Home Facility | — | NC | Yes |

## Other

- **Enumeration date:** 08/05/2007
- **Last updated:** 08/05/2007