Organization
ACTIVE CARE SERVICES
Active
Other names
PRO-ACTIVE CARE SERVICES
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CECILIO CHIO BANA JR. (OWNER)
(818) 920-7147
Entity
Organization
Contact information
Practice address
14747 ROSCOE BLVD, #19, PANORAMA CITY, CA 91402-4145
(818) 920-7147
Mailing address
14747 ROSCOE BLVD, #19, PANORAMA CITY, CA 91402-4145
(818) 920-7147
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
0002167408-0001-1
CA
253Z00000X
In Home Supportive Care Agency
0002167408-0001-1
CA
Other
Enumeration date
10/01/2008
Last updated
10/01/2008
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