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Organization

ACTIVHEALTHCARE, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. MARK BRICKHOUSE (EXECUTIVE DIRECTOR)
(770) 455-0040
Entity
Organization

Contact information

Practice address
1926 NORTHLAKE PKWY STE 100, TUCKER, GA 30084-7069
(770) 455-0040
(770) 455-6188
Mailing address
1926 NORTHLAKE PKWY STE 100, TUCKER, GA 30084-7069
(770) 455-0040
(770) 455-6188

Taxonomy

Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary

Other

Enumeration date
02/08/2007
Last updated
09/15/2021
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