Organization
ACTIVE LIFE ADHC LLC
Active
Organization
ACTIVE LIFE ADHC LLC
Active
Other names
Active Life ADHC LLC
Organization subpart
No
Provider details
NPI number
Authorized official
VITA COKER (EXECUTIVE DIRECTOR)
(502) 835-9419
Entity
Organization
Contact information
Practice address
102 BOOKSTORE WAY, BOWLING GREEN, KY 42101-2810
(502) 835-9419
Mailing address
102 BOOKSTORE WAY, BOWLING GREEN, KY 42101-2810
(502) 835-9419
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
—
—
Other
Enumeration date
10/18/2023
Last updated
10/18/2023
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