Organization
ACTIVE SC ONE, INC.
Active
Other names
Club Horizons of Charleston
Organization subpart
No
Provider details
NPI number
Authorized official
DEBORA HOCKENBURY (CONTRACTS MANAGER)
(215) 642-6600
Entity
Organization
Contact information
Practice address
8088 RIVERS AVE, NORTH CHARLESTON, SC 29406-9235
(843) 992-2432
Mailing address
6 NESHAMINY INTERPLEX, SUITE 401, TREVOSE, PA 19053
(215) 642-6600
(215) 642-6610
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
01/09/2019
Last updated
10/20/2022
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