Organization
ACTIVE HOME CARE INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JUSTIN CODY WILLIS (PRESIDENT)
(941) 564-8621
Entity
Organization
Contact information
Practice address
2565 N TOLEDO BLADE BLVD, NORTH PORT, FL 34289-9306
(941) 564-8621
(941) 429-3322
Mailing address
2565 N TOLEDO BLADE BLVD, NORTH PORT, FL 34289-9306
(941) 564-8621
(941) 429-3322
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
05/27/2014
Last updated
05/27/2014
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